PTOS 5.6 - User`s Guide

Patterson PTOS 5.6
User’s Guide
PTOS
Volume II
©2012 Patterson Medical Supply, Inc. All rights reserved.
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All other trademarks, which appear in these pages, are the property of their respective owners.
COPYRIGHT NOTICE
This software and operations manual are both protected by U.S. Copyright Law that (Title 17 United
States Code.) This software and publication have been provided subject to a license agreement which
restricts their use. No part of this software or user manual may be copied or distributed, disclosed,
transmitted or reduced to any electronic medium without the express written permission of PTOS
Software, A Patterson Medical Company. Infringement of copyright can result in criminal prosecution,
fines and imprisonment, in addition to civil damages.
DISCLAIMER
This software and manual are provided on an “as is” basis. Except for the warranty described in the
PTOS software license agreement, there are no warranties expressed or implied, including but not limited
to implied warranties of merchantability or fitness for a particular purpose, and all such warranties are
expressly and specifically disclaimed.
In no event shall PTOS Software, A Patterson Medical Company, be responsible for any indirect or
consequential damages or lost profits, even if PTOS Software, A Patterson Medical Company, had been
advised of the possibility of such damage.
Patterson PTOS
1201 Althoff Dr.
Effingham, IL 62401
Technical Support 800.824.4305
Technical Support Fax 217.342.4571
User’s Guide – Patterson PTOS 5.6
Contents  i
Contents
PTOS
1 System Requirements ................................................................................................................ 1 Local Area Network .................................................................................................................. 1 Keyboard Shortcut Keys ............................................................................................................ 2 Logging On ................................................................................................................................ 2 The PTOS Login Menu ............................................................................................... 2 Main Screen Logo Graphics ...................................................................................................... 3 Check for Updates ..................................................................................................................... 3 Using PTOS
5 Setting Up PTOS ....................................................................................................................... 5 Setting Up Your Facility Information ........................................................................................ 5 Setting Up Your Employees ...................................................................................................... 6 User Access Rights .................................................................................................................... 8 Config Parameters ................................................................................................................... 10 Config Groups ........................................................................................................... 10 eClaims Setup .......................................................................................................................... 14 Patients..................................................................................................................................... 15 Patient Case Tab ........................................................................................................ 15 Referral/Employer Tab .............................................................................................. 18 Bill Tab ...................................................................................................................... 20 HCFA/UB04 .............................................................................................................. 21 HCFA ........................................................................................................................ 23 UB04 ......................................................................................................................... 24 eClaims Attachment Information .............................................................................. 26 Insurance Tab ............................................................................................................ 30 Enter the Primary insurance first and then follow in descending order for any
additional insurance carriers. ..................................................................................... 30 Notes Tab .................................................................................................................. 31 Cogwheel ................................................................................................................... 31 Cogwheel Options Menu ........................................................................................... 32 Update Lists Information ......................................................................................................... 33 Insurance Companies................................................................................................. 33 Referrals .................................................................................................................... 35 Update Account Type Codes ..................................................................................... 36 Employers.................................................................................................................. 39 Zip Codes .................................................................................................................. 39 Lookup Table ............................................................................................................ 40 Payment Types .......................................................................................................... 40 Adjustment Type ....................................................................................................... 41 Transaction History Legends ..................................................................................... 42 ICD9 Codes ............................................................................................................... 43 Update C.P.T. Codes ................................................................................................. 43 C.P.T. Group ............................................................................................................. 44 Fee Schedule.............................................................................................................. 45 Attaching Fee Schedules to Patients .......................................................................... 48 Attaching Fee Schedules to Insurance Companies .................................................... 48 LCD Datasets ............................................................................................................ 49 CCI Datasets .............................................................................................................. 50 User’s Guide – Patterson PTOS 5.6
Contents  ii
Scheduling
52 Scheduler Setup ....................................................................................................................... 52 Resources .................................................................................................................. 52 Appointment Status ................................................................................................... 53 Appointment / Block Hold Type ............................................................................... 53 Appointment Reminder Email Template ................................................................... 54 Scheduling an Appointment..................................................................................................... 55 Scheduling a Single Appointment ............................................................................. 55 Scheduling Multiple Appointments ........................................................................... 56 Additional Therapists ................................................................................................ 57 Additional Resources................................................................................................. 57 New Appointment (from Waitlist) ............................................................................ 58 Scheduling Blocks ................................................................................................................... 58 Creating a Single Block ............................................................................................. 58 Creating Multiple Blocks .......................................................................................... 59 Additional Therapists ................................................................................................ 60 Additional Resources................................................................................................. 60 Delete Block Hold ..................................................................................................... 61 Editing Appointments .............................................................................................................. 61 Checking In an Appointment ..................................................................................... 61 Cancelling an Appointment ....................................................................................... 61 No-Show Appointments ............................................................................................ 62 Reschedule................................................................................................................. 63 Voiding an Appointment ........................................................................................... 63 Additional Right-Click Options ............................................................................................... 64 Collect Co-Pay .......................................................................................................... 64 Enter Charges ............................................................................................................ 65 Note Complete ........................................................................................................... 66 Copy .......................................................................................................................... 66 Cut ............................................................................................................................. 66 Paste .......................................................................................................................... 66 Patient Editor ............................................................................................................. 66 Print Appointment Card ............................................................................................ 66 Print Superbill............................................................................................................ 67 Schedule Calendar View.......................................................................................................... 67 Schedule Views ......................................................................................................... 67 Show CXL/NS Appointments ................................................................................... 67 Send Email Reminder ................................................................................................ 68 Print Preview ............................................................................................................. 68 Schedule Appointments View ................................................................................................. 68 Transfer Appointment .............................................................................................................. 69 Waitlist..................................................................................................................................... 70 Appointment / Block Void ....................................................................................................... 70 Voiding Blocks .......................................................................................................... 71 Documentation
72 Template Admin ...................................................................................................................... 72 Header ....................................................................................................................... 72 Additional Options .................................................................................................... 73 Edit Template .......................................................................................................................... 73 Paragraph Status ........................................................................................................ 73 Show/Hide Detail ...................................................................................................... 74 Copy from Note ......................................................................................................... 74 Pick Lists ................................................................................................................................. 74 User’s Guide – Patterson PTOS 5.6
Contents  iii
Patient Chart ............................................................................................................................ 75 Creating a New Note ................................................................................................. 75 Saving a Note ............................................................................................................ 76 Comparing Initial Evaluation with Re-Evaluation .................................................... 78 Note History .............................................................................................................. 79 Open Note Options .................................................................................................... 79 Closed Note Options.................................................................................................. 81 Facility Logo............................................................................................................................ 82 Billing
84 Transactions ............................................................................................................................. 84 Enter Charges .......................................................................................................................... 84 Entering Billing information ..................................................................................... 86 Group 1 — Previous Patient Balance (excludes current charges) ............................. 88 Group 2 — Case Information (includes current charges) .......................................... 88 Group 3 — Today’s Charges (includes current charges)........................................... 88 Charge Ticket ............................................................................................................ 89 Appointment Warning Messages............................................................................... 90 Payments/Adjustments ............................................................................................................ 91 Account Payment ...................................................................................................... 91 Insurance Payments ................................................................................................... 92 Adjustments ............................................................................................................... 93 Insurance Payment Windows .................................................................................... 95 X-Charge Electronic Payment Processing ............................................................................... 95 System Voids on Overpayments................................................................................ 97 Patient Transactions ................................................................................................................. 97 Summary Tab ............................................................................................................ 97 Cogwheel ................................................................................................................... 98 Overpayments - Patient Transactions ........................................................................ 99 History Tab .............................................................................................................. 100 Daily Transactions (Charges) ................................................................................................ 102 Approved Charges ................................................................................................... 102 Cogwheel ................................................................................................................. 103 UnApproved ............................................................................................................ 103 Payment ................................................................................................................... 104 Adjustment .............................................................................................................. 105 CCI/LCD Audits...................................................................................................... 105 Void a Transaction .................................................................................................. 106 Applying Co-pay ..................................................................................................... 106 Auto-calculating Accounts Receivable.................................................................... 107 Account Aging ........................................................................................................ 107 Inactive Accounts .................................................................................................... 107 Date Range Information .......................................................................................... 107 Claims .................................................................................................................................... 107 Patient Billing ........................................................................................................................ 113 Standard Options ..................................................................................................... 114 The Statement Queue .............................................................................................. 117 Insurance Billing .................................................................................................................... 117 Insurance Billing Sort Tab....................................................................................... 118 Standard Options Tab .............................................................................................. 119 Claims Queue Tab ................................................................................................... 120 Navigate To ............................................................................................................. 121 eClaims Setup Tab................................................................................................... 122 Auto Assign Payer ID .............................................................................................. 123 Setting up Unpaid Balances..................................................................................... 124 User’s Guide – Patterson PTOS 5.6
Contents  iv
Using Unpaid Balances ........................................................................................... 125 Claims .................................................................................................................................... 126 ERA ....................................................................................................................................... 126 View ERA in Claims ............................................................................................... 127 The ERA Queue ...................................................................................................... 127 Overpayments - ERA Payments .............................................................................. 128 Bulk Payments ......................................................................................................... 128 Date of Service Filter............................................................................................... 128 Flexible Bulk Payment Distribution ........................................................................ 129 Overpayments - Bulk Payment Windows................................................................ 130 HIPAA (ASC) X12 Version 5010 Standard .......................................................................... 131 Worklist
132 Using the Worklist ................................................................................................................. 132 Appointments .......................................................................................................... 132 Notes........................................................................................................................ 132 Interfaces
133 Using Interfaces ..................................................................................................................... 133 Config Parameters ................................................................................................... 133 Exported Files.......................................................................................................... 133 One Time Export ..................................................................................................... 134 Import Files ............................................................................................................. 134 Reports
136 Report Options ....................................................................................................................... 136 Report Views ........................................................................................................... 136 Export Options ........................................................................................................ 136 Favorites .................................................................................................................. 137 Aged Accounts Receivable Reports....................................................................................... 137 Customized Date Range A/R Report ....................................................................... 138 Analysis Reports .................................................................................................................... 139 Treatment Lists ...................................................................................................................... 140 Financial Lists........................................................................................................................ 141 Demographic Lists ................................................................................................................. 142 Code Lists .............................................................................................................................. 142 Transaction Lists .................................................................................................................... 143 Documentation Reports ......................................................................................................... 144 Scheduling Reports ................................................................................................................ 144 System Tasks
146 Supervisor .............................................................................................................................. 146 Config Parameters ................................................................................................... 146 Data Sources ............................................................................................................ 147 Facility ..................................................................................................................... 147 Employee ................................................................................................................. 147 Merchant Services Setup ......................................................................................... 148 User Access Rights .................................................................................................. 150 User Groups............................................................................................................. 150 Check for Updates ................................................................................................... 151 Update Lists ........................................................................................................................... 151 Login Summary ..................................................................................................................... 151 Currently Logged Summary .................................................................................... 152 User’s Guide – Patterson PTOS 5.6
Contents  v
Object Lock Details ............................................................................................................... 152 Export Application Errors ...................................................................................................... 152 Technical Support Utility....................................................................................................... 153 System Copy............................................................................................................ 153 Copy Size ................................................................................................................ 154 Restore Copy ........................................................................................................... 155 Special Tasks
156 Remove Old Accounts ........................................................................................................... 156 Inactivate Cases ....................................................................................................... 156 Archive Patients ...................................................................................................... 156 Add/Update Client Logo........................................................................................................ 157 Tools
158 Worklist ................................................................................................................................. 158 Login as Different User ......................................................................................................... 158 Help
159 PTOS Help Menu .................................................................................................................. 159 Online Center ......................................................................................................................... 159 Contact Support ....................................................................................................... 159 FAQ ......................................................................................................................... 159 About PTOS .......................................................................................................................... 160 System Backups ..................................................................................................................... 160 Creating Your Backup ............................................................................................. 160 Storing Your Backup ............................................................................................... 160 Glossary of Terms
161 PTOS Website
165 Additional Seminars ................................................................................................ 165 FAQ ......................................................................................................................... 165 Enhancement Suggestions ....................................................................................... 165 Support .................................................................................................................... 165 Index
User’s Guide – Patterson PTOS 5.6
166 Contents  vi
PTOS
System Requirements
Memory – We recommend a minimum of 2 gigabytes of memory
for a server/workstation. (Recommend 4 gigabytes or higher for
best results)
Display – PTOS for Windows requires a monitor with a video
resolution capable of 1024 x 768.
High Speed Internet – PTOS requires high speed Internet
connection when downloading updates.
Web Browser – PTOS recommends using Internet Explorer when
downloading updates from our website.
Local Area Network
If you will be running PTOS on a network, there are several
considerations to keep in mind. First, you MUST have a MultiUser version of PTOS.
Operational Considerations – The Network version of PTOS
allows a high degree of freedom when using various data entry
and reporting routines. As with any multi-station data entry
system, however, certain precautions should be taken into
consideration. These considerations can be summed up in one
statement: “No data can be entered that will affect the results of
another operation taking place at that same time.” Specific
considerations are listed below.
User’s Guide – Patterson PTOS 5.6

PTOS requires Administration Rights to the PTOS
folder and all of its sub-folders and files. In addition, all
workstations must have Administration Rights to their
local temp folder and its files.

You can direct printing to any printer on the network by
selecting Special Tasks  Print Administrator.
Printing can also be redirected at the time sending
output to a printer is selected. If you use print spooling,
it is up to your hardware consultant to set the spooler
PTOS  1
correctly. If this is not set correctly, documents can be
lost.
Keyboard Shortcut Keys
The following is a list of function keys that can be used in PTOS:
F2 – Use this key to Add a new item in a list.
F3 – Use this key to Edit an existing item in a list.
F5 – Use this key to search an existing list.
% – Use this key in a search field to open the entire list of options.
Logging On
Double-click the PTOS icon or select PTOS from the Program list.
The PTOS Login Menu
Database: Select your main
database for daily work or
your archive database.
The system date will default to today’s date; however; the option
to return to a previous system date is available. Use the dropdown menu to select a Database. Enter a username and
password to log into PTOS.
To exit PTOS, select Exit on the toolbar.
User’s Guide – Patterson PTOS 5.6
PTOS  2
Select Yes to exit. Select No to continue.
Main Screen Logo Graphics
To access the PTOS Background Image preference, go to
Special Tasks | Show PTOS Background Image and check this
feature to have the main screen appear upon opening the
software. Uncheck if the main screen is not wanted upon startup.
Check for Updates
Periodically, it is necessary to check for updates to your PTOS.
Before you update your software, it is recommended that you
have a verified backup that can be restored if necessary.
To check for updates, select System Tasks  Supervisor  Check
for Updates.
Select Yes to continue. Select No to exit without continuing.
User’s Guide – Patterson PTOS 5.6
PTOS  3
To continue downloading updates, select Yes. Select No to exit
without updating. The following window appears.
Select OK to finish installing updates.
Select OK to launch the PTOS application.
User’s Guide – Patterson PTOS 5.6
PTOS  4
Using PTOS
Setting Up PTOS
Before you can realize the full potential of PTOS, you must set up
the basic information. This chapter will walk you through the basic
setting up of PTOS for your office needs.
Setting Up Your Facility Information
The Tax ID number cannot be
edited from this screen. This
number is supplied by your
licensing information.
Under System Tasks | Supervisor | Facility enter your facility
information. Enter your demographic information including
Scheduling Start/End time and Scheduling Time Duration.
In the PTPN Information section, enter the Office and DBA
information.
Select the checkboxes to designate this facility as the Insurance
Billing Remittance Facility and/or Patient Billing Remittance
Facility.
User’s Guide – Patterson PTOS 5.6
Using PTOS  5
Select the Practice Identification button to enter additional
identification numbers such as License, UPIN and insurance
group numbers.
Select OK to save.
Setting Up Your Employees
Required fields are denoted
with asterisks.
Under System Tasks | Supervisor | Employee, create and/or
edit the employees of your facility. If you have purchased the
Scheduling program separately, you will need to create all
employees: both therapists and office staff. While creating/editing
User’s Guide – Patterson PTOS 5.6
Using PTOS  6
an employee, all the areas indicated by a red asterisk must be
filled out to save this employee.
To create a new employee, select the Add icon. Enter the Emp
ID. In the next section, enter the employee’s name, User Name,
Password and Nickname/Gender, if desired.
Under the Billing Provider Information, enter the Employee’s
Name, Address, City/State/Zip and NPI #. Also include the
Phone number(s), Email, Birth and Hire Dates, Title,
Terminated Date, Hourly Rate, Sort Order and Notes.
Under Force Password Change, select either Next Login or an
Expiration date.
Required for therapists.
Enter the employee’s NPI # (if applicable), Tax ID number (if
applicable), NY state License (if applicable), Ohio Provider # (if
applicable), Social Security Number, Taxonomy code, and
Statement Header.
Select Employee type and Provider on Insurance physician.
Select the Default Facility and any additional Facilities for this
employee.
User Group ID – This area allows you to set up the different
access levels for your employees.
Therapist Group – All employees must be assigned a Therapist
Group. If the employee is not a therapist, it will not have any
effect on the schedule.
Signature Line – This area must be filled out by all Therapists.
The information in this area is how the employee’s electronic
signature will look.
Signature File for Documentation – Browse to the location in
which you wish to save the signature file.
Site ID
Do not alter this area without the
assistance of PTOS support.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
User’s Guide – Patterson PTOS 5.6
Using PTOS  7
Select the Site ID button to select the Site ID from the available
options.
Therapist Info
Select Therapist Info to assign the required numbers for
Insurance Claims by Account Type.
User Access Rights
To establish administration rights for users, select System Tasks 
Supervisor  User Access Rights.
User’s Guide – Patterson PTOS 5.6
Using PTOS  8
Under User Groups, select the group name. The areas
associated with this User Group appear below. Select or
deselect the checkboxes that allow group members to View or
Modify the selected areas of PTOS. Items with a single level of
access will have View and Modify linked automatically.
User Groups are assigned to employees in the Employee
screen. Another way to assign employees to User Groups is
under System Tasks  Supervisor  User Groups.
Select the User Group drop-down arrow to select a User Group.
Select, Add Employees to User Group, to add employees. Use
the red X to remove an employee.
Select the checkbox associated with the desired employee.
Select OK.
To create a new User Group, select the Add icon or F2. Enter
the description information and save.
To delete an existing User Group, select the desired group and
select the Delete icon.
User’s Guide – Patterson PTOS 5.6
Using PTOS  9
Config Parameters
Configure your preferred settings using Config Parameters.
Select System Tasks  Supervisor  Config Parameters.
Use the drop-down list to select a Config Group or leave this
area blank to view all available options. Select the Edit icon or F3
to edit the selected parameter.
Edit the Value to suit your office’s needs. Select the Save icon to
save your changes.
Config Groups
Config Groups are parameters that affect the same area of the
software. The following Config Groups are available.
Billing
User’s Guide – Patterson PTOS 5.6
Using PTOS  10
Charge Ticket – Choose whether to see the Charge Ticket or
Enter Charges screen when entering charges from Scheduling
and/or Documentation. This DOES NOT impact entering
charges from Patient Editor or the Billing menu. Value: 1 =
Charge Ticket, 2 = Enter Charges, 0 = Neither.
AuditCheck – Value: 'Yes' = Prompt will appear during charge
entry to audit codes using CCI/LCD edits. 'No' = Prompt will not
appear during charge entry.
Filter Charge Ticket/Superbill – 1= Filter by 3.6 BCT. 2 = Filter
by 4.5 Fee Schedule. 3 = Using 3.6 BCT but do not automatically
filter codes. 4 = Using 4.5 Fee Schedule but do not automatically
filter codes.
Tax Percentage – Value: Set up the sales tax percentage to be
used on taxable services. This will be used on codes marked as a
Taxable Services in C.P.T. Code setup.
System Lock – Enter a closing date to create a lock disabling
modification of transactions dated prior to that date. To disable
the temporary lock, remove the date or enter a new date.
Auto Adjust – Value: 'Yes' = write-off amounts will automatically
default when posting insurance payments. 'No' = write-off
amounts will not default when posting insurance payments.
A/R Details on Daily Transaction Report – Yes = A/R totals will
be printed at the bottom of report. No = Totals will not print at
bottom of report.
Charge Limit Warning Threshold – User can specify to be
warned within x amount of patient’s charge limit.
ERA Group Codes To Ignore – If using Electronic Remittance
Advice, specify the group code.
Use Partial Automatic (not Manual) distribution setting in
Bulk Payments. ‘Yes’ = USER manually distributes payment
amount per claim & SYSTEM automatically distributes to services
on each claim. ‘No’ = SYSTEM automatically distributes ALL
(payment amount per claim & services).
Bulk Payment Facility Default – 1 = Patient’s Assigned Facility.
2 = Treating Facility for the Claim.
Document
Set Watermark – Type text to appear as a diagonal watermark on
closed notes (Ex: Confidential, Closed, etc.).
User’s Guide – Patterson PTOS 5.6
Using PTOS  11
Print Flow sheet in Landscape – 'Yes' = Flow Sheet prints in
landscape format. 'No' = Flow Sheet prints in portrait format.
Prompt to save patient notes – 'Yes' = User prompted in
Documentation to Save when exiting a note. 'No' = the System
will automatically Save everything without prompting.
eMail/Fax
Mail Host – Enter the Simple Mail Transfer Protocol (SMTP)
server for outgoing messages, or the email provider's SMTP
outgoing address. This information can be provided from your
Internet Service Provider (ISP) or network administrator.
*Required for email and fax capabilities.
Mailuser – Enter the email address used to send emails from
PTOS. *Required for email and fax capabilities.
Mailpwd – Specify the password provided by the Internet Service
Provider. *Required for email and fax capabilities.
MailSubject – Enter the subject line for appointment reminder
emails sent to patients.
Mailport – Specify the port number to connect to on the outgoing
email (SMTP). *Required for email and fax capabilities.
faxEmailServices – Specify the email address extension (such as
@efax.com or @myfax.com) used by the email fax service. PTOS
links the recipient's fax number and the faxEmailServices field to
form the email address of the fax.
Fromemail – Specify the email address PTOS will be using while
sending email/e-fax.
Fromname – Specify the name the email sent from PTOS
appears to be from (Example – American Rehab Clinic). This
name will appear in the From box of outgoing messages.
Use SSL – ‘Yes’ = the email account in use supports SSL
encryption. ‘No’ = the email account in use does not support SSL
encryption.
User’s Guide – Patterson PTOS 5.6
Using PTOS  12
Interface
PTPN Account Output Folder Path – Specify the path to the
folder where PTOS will deposit PTPN files.
Export DATA folder – Specify the paths to the folders where
PTOS will deposit the third party software import files.
Export DATA Format – Designate a file format for exported files.
(xml)
Import DATA Folder – Specify the path to the folder where PTOS
will retrieve the third party software export files.
Import DATA Format – Designate a file format for imported files.
(xml)
Scheduling
NO of schedule columns – Designate the number of columns to
display in the daily schedule view.
Print co-pay receipt – 1 = Co-pay receipt will print after payment
is collected. 0 = Co-pay receipt will NOT print after payment is
collected.
System
User Defined Field – Specify the label of the user defined field
that appears in Patient Editor.
Dbbackup – Designate the path to a folder where the data
backups will be stored.
Assign Patient ID – 'Yes' = System automatically increments and
assigns patient IDs for new patients. 'No' = User is responsible
for manually entering unique patient IDs for new patients.
User’s Guide – Patterson PTOS 5.6
Using PTOS  13
eClaims Setup
To setup your eClaims information, go to Billing  Insurance
Billing  eClaims Setup.
Reports can be manually
purged from the Claims
Queue.
Under Clearinghouse Settings, select the eClaims Provider and
select the ellipsis button to enter the eServices User and
Password information. Select the Browse button to locate a
different path for Other Clearinghouse Image Files. Enter the
Image File Name.
Under Default Reports to be Printed, select the checkbox
associated with the report that you would like to print every time
claims are processed. The available reports include:
Acknowledgement of
Receipt
Amended File Detail
(RPT04A)
997
Batch & Claim Rejection
(RPT05)
File Status (RPT02)
Amended Batch & Claim
Rejection (RPT05A)
File Summary (RPT03)
Provider Claim Status
(RPT10)
File Detail (RPT04)
Special
Handling/Unprocessed
claims (RPT11)
Under Reports Settings, enter a Purge Reports after number to
designate a number of days to keep reports prior to purging.
Select the Save button to save information. Select Close to exist
the screen.
User’s Guide – Patterson PTOS 5.6
Using PTOS  14
To assign Payer ID information automatically, use the Auto
Assign Payer ID.
Patients
Enter the Patient Case, Referral/Employer, Bill information and
more. Patient information is Case specific in all areas except for
Patient Information, Emergency Information and Personal
Information.
Patient Case Tab
To search for existing Patients, enter a patient name in the
Search field. Once the correct patient has been selected, use the
Case drop-down menu to select a different case, if desired.
Patient Information
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
To enter a new patient, select the Patients menu  New Patient
or select the New Patient icon. In the Patient Information
section, enter the following information:
User’s Guide – Patterson PTOS 5.6

Patient ID (NOTE: based upon Config Parameters, this
field may have a default entry)

Primary Facility

Name

Nickname/Gender

DOB/SSN #

Privacy Notification Date

Privacy Notification Expiration Date

Scheduling Pref.

Scenario (NOTE: This field can be edited to say
anything)
Using PTOS  15
Emergency Information
In the Emergency Information section, enter the Contact Name,
Relationship and Phone number for the patient’s emergency
contact.
Personal Information
In the Personal Information section, enter the patient’s address,
email and contact number information. Select the OK to Contact
checkboxes corresponding to the patient’s desired phone number.
Case Information
In the Case Information section, enter the following information:
User’s Guide – Patterson PTOS 5.6

First Visit Date and Hour

Fee Schedule

Injury Area

Injured Date
Using PTOS  16

Account Type

Dropout Date

Assigned Therapist

Discharge Date and Hour

Assigned Facility

Discharge Info

Admit Condition

Discharge Condition

Discipline

Delinquency Report Note

Case Note
Select the PTPN checkbox if the patient is a PTPN member.
Responsible Party
Relation to Patient – Use the drop-down menu to select the
relationship information.
Name – Enter the name of the Responsible Party.
Address – Enter the address of the Responsible Party.
City/State/Zip – Enter the city, state and zip code for the
Responsible Party.
Diagnosis/Additional ICD9 Codes
In the Diagnosis section, enter the Primary ICD9 and any
subsequent codes. Enter the Default Diagnosis number.
User’s Guide – Patterson PTOS 5.6
Using PTOS  17
Under the Additional ICD9 Codes, enter any additional ICD9
codes.
Referral/Employer Tab
Enter any necessary referral or patient employer information in
this tab.
Referring Physician
Use the Search area to locate an existing Physician.
Enter the name of the referring physician. Review the Address,
Specialty/UPIN/NPI code, phone/fax and email information.
Enter any Notes that apply. Use the drop-down menu to select
the Referral Date and Next Physician Appointment.
User’s Guide – Patterson PTOS 5.6
Using PTOS  18
Attorney/Case Manager
Use the Search area to locate an existing Attorney/Case
Manager.
Enter the Name of the Attorney/Case Manager. Review the
information, Address, Phone/Fax and Specialty pertaining to this
case. Enter any applicable Notes.
Primary Care Physician
Use the Search area to locate an existing Primary Care
Physician.
Enter the Name. Review the following information: Address,
Specialty/UPIN/NPI code, Phone/Fax and Email information.
Make any Notes necessary.
User’s Guide – Patterson PTOS 5.6
Using PTOS  19
Employer Details
Use the Search area to locate an existing Employer Details.
Review the Employer ID and Name, Address and Phone. Enter
the Patient occupation information.
Bill Tab
In the Bill Tab, enter billing information pertaining to the patient.
In the first section, enter the following information:
User’s Guide – Patterson PTOS 5.6

Authorization Expiration Date

Authorized Visits – the number of visits recorded

Remaining Visits – the number of visits allowed minus the
authorized visits.

Maximum units per Day

Charges per Day

Co-Pay Amount
Using PTOS  20

Payment Plan Amount and Frequency

Posting Note
Select the Don’t Print Patient Statement checkbox to withhold
printing of statements for this case.
Select the Do Not Apply Finance Charge checkbox to withhold
finance charges.
In the Charge Limit section, enter the Effective Date and
Amount for Period 1 and Period 2. Use the drop-down to select
a date for Charge Limit warning based on.
Under Deductible, select the Period 1 and Period 2 Effective
Dates. Enter the Amount and Remaining Deductible Amount
for the available periods.
HCFA/UB04
In the HCFA/UB04 tab, enter insurance information for the
selected patient.
In the Additional CMS-1500/HCFA Boxes section, enter the
Patient Status, Patient Condition, State, and Reserved for
Local Use. For use in Box 12 enter the Date and check the Print
Signature checkbox. To receive HCFA payments, select the
checkbox Authorize Payment to Office.
User’s Guide – Patterson PTOS 5.6
Using PTOS  21
When sending eClaims, the PWK section is included with
applicable claims. In the Additional CMS-1500/HCFA Boxes
section, select the eClaims Attach. Info button.
HCFA Box 32A - Enter an Alternate Place of Service
(POS)
There is a new ability to enter an alternate address for Box 32 on
the HCFA form. This area allows for entry of place of service
name, address, and Box 32A/32B identifiers.
To enter an alternate POS go to Patient Editor | HCFA-UB04 tab.
In the top section for Additional CMS-1500/HCFA Boxes, there is
a new button next to Place of Service [24b] - 'Alternate Place of
Service Address'.
If the default POS of 11 is used, the information in box 32 will print
as it currently does using the treating facility information, found
under System Tasks | Supervisor | Facility.
If any other POS code is used (Ex: 12 = Home; 13 = Assisted
Living; 14 = Group Home; 21 = Inpatient Hospital) the new button
Alternate Place of Service Address will be enabled. Location,
Address and identifiers can be entered for services performed
outside of the office.
Complete the information for the Alternate Place of Service (POS)
and click OK.
User’s Guide – Patterson PTOS 5.6
Using PTOS  22
Additional UB04 Boxes
In the Additional UB04 boxes section, enter any necessary
insurance and condition codes for use by the Insurance.
The following information will assist you in properly filling out
insurance forms for HCFA and UB04 standards.
HCFA
1) Box 8 – Specify the patient’s marital and employment status.
2) Box 10 – Specify what the patient condition is related to.
3) Box 10, Box 10b – Is used to specify the state where the
auto accident took place (dependent upon Auto Accident being
selected in Box 10)
4) Box 10d – Used as a remarks field if insurance carrier
requests specific information that is not specified elsewhere on
the HCFA claim form.
5) Box 12 – Indicates whether the patient has given consent to
authorize the release of medical or other information
necessary to process the claim. If the date field is left empty,
then the patient’s first visit date should be used on the claim
form.
6) Box 13 – Indicates whether the patient has given authorization
for the insurance payment to be received by the office. This
authorization works in conjunction with the account type
setting to ‘Accept Assignment’.
7) Box 15 – Indicates if the patient has had the same or similar
illness; specify the date.
8) Box 16 – Indicates the dates that the patient is/was unable to
work in his or her current occupation.
9) Box 18 – Enter the admission and discharged date for any
hospitalization related to the current services. If the patient is
still in the hospital, leave the “To” section blank.
10) Box 19 – Use as a remarks field if an insurance carrier
requests specific information that is not specified elsewhere on
the HCFA claim form.
User’s Guide – Patterson PTOS 5.6
Using PTOS  23
11) Box 20 – Use to indicate whether this claim includes charges
for lab work performed by a licensed laboratory. A field to
specify the amount of the lab work is also available.
12) Box 22 – Medicaid resubmission claims only. Enter the
resubmission code in this box.
13) Box 23 – Used to specify the prior authorization number/s and
associated date range/s.
14) Box 24b – Used to indicate the place of service, such as:
a. 03-School
b. 11-Office
c. 12-Home
d. 13-Assisted Living Facility
e. 14-Group Home
f.
15-Mobile Unit
g. 20-Urgent Care Facility
h. 21-Inpatient Hospital
i.
22-Outpatient Hospital
j.
99-Other Place of Service
UB04
1) Box 4 (Type of Bill) – Enter the code to identify the type of
billing being submitted. The default codes are 0741-0744,
which designate treatment at an ‘Outpatient Rehabilitation
Facility’. The exact code is determined by whether this is the
original billing run or a re-bill, and whether primary or
secondary insurance. Enter any value in this box to overwrite
the PTOS default.
2) Box 14 (Type of Visit) – Used to enter the code indicating the
priority of this patient admission, such as:
a. 1- Emergency
b. 2- Urgent
c. 3- Elective
d. 4- Newborn
e. 5- Trauma
f.
9- Information not available. By default, PTOS should
leave this field blank. Using this option will leave box
14 blank.
3) Box 15 (Source of Referral) – Used to choose the
appropriate referral source of this patient admission such as:
User’s Guide – Patterson PTOS 5.6
Using PTOS  24
a. 1-Physician Referral – By
b. 2-Clinic Referral
c. 3-HMO Referral
d. 4-Transfer from Hospital
e. 5-Transfer from Skilled Nursing Facility
f.
6-Transfer from Another Health Care Facility
g. 7-Emergency Room
h. 8-Court/Law Enforcement
i.
9-Information Not Available.
4) Box 18-23 (Condition codes) – Used to enter up to 6
condition codes (3 characters each) for the patient. These
codes identify conditions that may affect the processing of the
claim.
5) Box 30 (Reserved) – Used as a remarks field if an insurance
carrier requests specific information that is not specified
elsewhere on the claim form.
6) Box 31A-35A (Occurrence) – Used to enter the 2 digit code
and corresponding date that identifies conditions that apply to
this billing period. Box 35 has space for the From and To
dates.
7) Box 31B-35B (Occurrence) – Used to enter the 2 digit code
and corresponding date that identifies conditions that apply to
this billing period. Box 35 has space for both a From and To
date.
8) Box 39-41 – Used to indicate the value codes and amounts for
primary and secondary insurance. PTOS leaves this box
blank by default.
9) Box 45 – Leave Box 45 Empty (primary) contains the date of
service and PTOS populates it by default. If this option is
checked, it will be left empty when billing primary.
10) Box 45 – Leave Box 45 Empty (secondary) contains the date
of service and PTOS populates it by default. If this option is
checked, it will be left empty when billing secondary.
11) Box 50A-C (Payer Name) – Default the name of the primary
insurance in 50A, secondary in 50B, and tertiary in 50C.
Entering any values here will overwrite these defaults. Some
providers may have their own custom requirements for this
box.
12) Box 63 (Treatment Authorization Codes) – Used to enter up
to 3 assigned authorization numbers, if applicable.
13) Box 64 – Used to enter the document control number for a
claim.
User’s Guide – Patterson PTOS 5.6
Using PTOS  25
14) Box 66 – Leave Box 66 empty. We recommend that you leave
this box empty. Used to indicate the diagnosis version
qualifier. The default value printed by PTOS is 9 to indicate
ICD9 codes. Several payers do not want the 9 to print in this
box, so checking this option will clear box 66.
15) Box 69 (Print Primary ICD9) – Used to denote the diagnosis
that describes the patient’s condition or reason for
admission/outpatient registration. By default, this will be left
blank. If checked, the patient’s primary diagnosis code will
print.
16) Box 74 (Principal) – Used to enter the principal diagnosis
code and date. It is required on inpatient claims when a
procedure was performed.
17) Box 74A-E (Other Procedures) – Used to enter any
additional diagnosis codes and dates.
18) Box 76 (Qualifier) – Used for the referring Dr.’s name, NPI
number and a second identifier. If second identifier is
provided, it may need to be accompanied by a 2 character
qualifier code in the “qual” field of box 76. Default for this field
is empty. Generally accepted qualifiers are:
a. 0B (state license #)
b. 1G (UPIN #)
c. G2 (Commercial #)
19) Box 80 – Use this area for Remarks for Unusual Services.
20) Box 81 A-D – Free form area that allows the user to enter
additional taxonomy numbers and qualifiers for boxes 81A-D
on the UB04 form. By default, this will be left blank.
eClaims Attachment Information
eClaims Attachment Information
Drop-down lists of attachments that relate to eClaims can be
located in the Patient Editor | HCFA tab. Locate the button in the
top section - Additional CMS-1500/HCFA Boxes - 'eClaims Attach
Info'.
User’s Guide – Patterson PTOS 5.6
Using PTOS  26
Attachment Report Type Code
Remove these settings after
sending the requested
attachment to avoid resending
the attachment information on
subsequent claims.
In the Attachment Report Type Code drop-down list, the
following possibilities are available to describe the type of
attachment:
User’s Guide – Patterson PTOS 5.6

Admission Summary – AS

Allergies/Sensitivities Document – A3

Ambulance Certification – AM

Autopsy Report – A4

Baseline – BS

Benchmark Testing Results – BR

Blanket Test Results – BT

Certification – CT

Certified Test Report – 13

Chemical Analysis – 11

Chiropractic Justification – CB

Consent Form(s) – CK

Continued Treatment – 10

Death Notification – V5

Dental Models – DA

Diagnostic Report – DG

Discharge Monitoring Report – DJ

Discharge Summary – DS

Drug Profile Document – D2

Drugs Administered – 04

Durable Medical Equipment Prescription – DB

Explanation of Benefits (Coordination of Benefits or
Medicare Secondary Payer) – EB

Functional Goals – 07

Health Certificate – HC
Using PTOS  27
User’s Guide – Patterson PTOS 5.6

Health Clinic Records – HR

Immunization Record – I5

Initial Assessment – 06

Justification for Admission – 15

Laboratory Results – LA

Medical Record Attachment – M1

Models – MT

Nursing Notes – NM

Objective Physical Examination (including vital signs)
Document – OE

Operative Notes – OB

Orders and Treatments Document – OD

Oxygen Content Averaging Report – OC

Oxygen Therapy Certification – OX

Paramedical Results – PQ

Parenteral or Enteral Certification – PE

Pathology Report – P4

Patient Medical History Document – P5

Photographs – XP

Physical Therapy Notes – PN

Physical Therapy Certification – PZ

Physician Order – B3

Physician’s Report – PY

Plan of Treatment – 08

Prescription – B2

Progress Report – 09

Prosthetics or Orthotic Certification – PO

Radiology Films – RB

Radiology Reports – RR

Recovery Plan – 21

Referral Form – B4

Renewable Oxygen Content Averaging Report – RX

Report Justifying Treatment Beyond Utilization Guidelines
– 03
Using PTOS  28

Report of Tests and Analysis Report – RT

State School Immunization Records - IR

Support Data for Claim – OZ

Symptoms Document – SG

Treatment Diagnosis – 05
Attachment Transmission Code
In the Attachments Transmission Code section, use the dropdown list to select the desired delivery method for sending the
requested documentation to the payer. These options include:

Available on Request at Provider Site – AA

By Fax – FX

By Mail – BM

By eMail – EM

Electronically – EL

File Transfer – FT
Attachment Control Number
In the Attachment Control Number section, enter the Document
Control Number (DCN) provided by the Payer. This number
identifies the claim and the attachment for the payer. An
Attachment Control Number is not required when using the
Available on Request at Provider Site option in the Attachment
Transmission Code section.
User’s Guide – Patterson PTOS 5.6
Using PTOS  29
Insurance Tab
To access patient insurance information, select Patient Editor |
Insurance tab. This screen displays all insurance for this case,
active or inactive. Select the Add Insurance button to add an
Insurance Company to a selected patient.
Multiple insurance companies can be added for a patient.
Enter the Primary insurance first and then follow in descending
order for any additional insurance carriers.
In the Insurance tab, view Insurance information for a selected
patient. Use the Add, Edit and Delete icons to alter information.
Insurance companies can be deactivated and reactivated using
the Reactivate button.
User’s Guide – Patterson PTOS 5.6
Using PTOS  30
Notes Tab
In the Notes tab, enter any notations for your personal office use.
Select the Add Note button to create a new note. Select the
Delete button to delete an existing note.
Select the Save icon to save this new patient information.
Double-click on an existing note to edit. Select the Report button
to create a report of all notes for a particular case.
Cogwheel
The Cogwheel provides a gateway to additional patient
information. Once inside Patient Editor click on the purple
cogwheel icon in the upper right of the screen to access.
User’s Guide – Patterson PTOS 5.6
Using PTOS  31
Cogwheel Options Menu
Cogwheel
Use the Cogwheel Options menu to:
Add New Case – Select this option to create a new case for the
selected patient.
Copy Case – Select this option to copy the current case
information into a new case.
Discharge Case – Select this option to designate a case as
discharged that will populate the discharge date.
Inactivate Case – Select this option to designate a zero balance
case as inactive.
Reactivate Case – Select this option to restore an inactive or
discharged case to active status.
Archive Patient – Select this option to mark a patient as ready for
archiving.
Enter Charges – Select this option to enter new charges for the
selected case.
Bill Patient Now – Select this option to open the Patient Billing
window for the selected case.
User’s Guide – Patterson PTOS 5.6
Using PTOS  32
Bill Insurance Now – Select this option to open the Insurance
Billing window for the selected case.
Payments/Adjustments – Select this option to open the
Payment/Adjustments window for the selected case.
Patient Transactions – Select this option to open the Patient
Transactions window for the selected case.
Recreate Claims – Select this option to recreate a claim.
Print Cover Sheet – Select this option to print a cover sheet for
the selected case.
Add New Appointment – Select this option to open the New
Appointment window for the selected case.
Add Patient to Waitlist – Select this option to include the
selected patient to the Waitlist.
Appointment Summary – Select this option to print a summary
report of appointments for the selected patient.
Co-Pay History – Select this option to print a summary of past copayments.
Print Blank Patient Questionnaire – Select this option to print a
blank patient registration questionnaire.
Print Blank Flow Sheet – Select this option to print a blank flow
sheet.
Patient Chart – Select this option to open the Chart for the
selected case.
Patient Charge History – Select this option to print a summary of
past charges for the selected case. (Displays up to 12 past
charges)
Update Lists Information
To begin entering and updating system codes, select System
Tasks  Update Lists. From this menu, select the specific code
list that you wish to update.
Insurance Companies
Select System Tasks  Update Lists  Insurance Companies.
Select an existing Insurance company from the search menu to
edit or select Add to create a new insurance company. To search
for a company, select the search icon.
User’s Guide – Patterson PTOS 5.6
Using PTOS  33
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
The asterisk denotes fields
that are required.
Insurance ID – Enter the 6 character alphanumeric Insurance ID
Name – Enter the name of the Insurance Company
Address – Enter the Address of the Insurance Company
City/State/Zip – Enter the City, State and Zip code for the
Insurance Company.
Phone – Enter the phone number for the Insurance Company.
Fax – Enter the fax number for the Insurance Company.
Pin# – Enter the PIN for the Insurance Company.
Group# – Enter the Group number for members of an Insurance
group.
Payment Group – Enter the name of the Payment Group if
applicable.
Percent Paid – Enter the percentage to be paid.
Practice Identification – Enter the Practice Identification
information. This number corresponds with the Facility setup ID
number.
Box 9D/lic line 1 – Information entered here will appear in box 9D
and 11C of the HCFA insurance form.
Box 9D/lic line 2 – Information entered here will appear in box 9D
and 11C of the HCFA insurance form
Print ‘Signature on File’ in Box 31 – Select this box to print the
phrase “Signature on File’ in Box 31 of the HCFA claim form, as
required by some insurance payers.
Fee Schedule – Enter the Fee Schedule to be associated with
this Insurance Company.
Four Digit Date – Select this checkbox to use the four digit year
date.
Insurance Claim Form – Select the desired default claim form to
be associated to this insurance company.
User’s Guide – Patterson PTOS 5.6
Using PTOS  34
Max Units per Day – Enter the maximum number of units per day
for the Insurance Company.
Email ID – Enter the email address for the Insurance Company.
WebSite – Enter the website associated with the Insurance
Company.
Notes – Enter any notes applicable.
Inactive – select the Inactive checkbox to remove active status.
Payer Info
EClaims Payer ID – Enter the eClaims payer id if applicable.
Payment Source – Enter the Payment Source for Payer. Use the
ellipses button to launch the Electronic Payer Matching screen.
From here, you can match names and sources manually.
DO NOT AUTO ASSIGN PAYER ID – When selected, this option
allows for payer IDs to be assigned automatically.
Enroll Provider Before Send eClaims – This option alerts you
that the Provider has not yet been enrolled in eClaims.
Referrals
Select System Tasks  Update Lists  Referrals. Use the
Search field to locate the desired referral. Select an existing code
to edit or select Add to create a new referral code.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
For assistance with adding or
removing Referral Types,
please contact the PTOS
Support team at 800.824.4305.
Referral sources can be doctors, attorneys, case managers or
nurse practitioners. Referral number is a one-to-five character
code that is assigned by the PTOS system.
Title – Select the preferred salutation.
Print Name – This is the referral source’s name as required in
Box 17 on the HCFA and Box 76 on UB04 forms. This also
prints on the Referral report to identify the referral source.
User’s Guide – Patterson PTOS 5.6
Using PTOS  35
First Name – Enter the first name of the referral.
Last Name – Enter the last name of the referral.
Address – Enter the address of the referral office
City/State – Enter the city and state of the referral office
Zip – Enter the zip code of the referral office.
Contact – Enter the main contact person’s name.
Office Phone #1 – Enter the main phone number for the referral
office.
Office Phone #2 – Enter the secondary phone number for the
referral office.
Fax – Enter the fax number associated with the referral office.
Email – Enter the email associated with the referral office.
Referral Type – Select the referral type from the drop-down
menu.
NPI (National Provider Identification) – This number is obtained
from the physician’s office and prints in Box 17B on the HCFA
and Box 76 on the UB04 forms.
UPIN (Universal Provider Identification Number) – This number
is assigned by Medicare Services and may or may not be required
to print on the claim forms. This six-digit alphanumeric code prints
in Box 17A on the HCFA and in Box 76 on the UB04 forms.
Specialty – Enter a specialty for report tracking purposes.
WebSite – Enter the website information associated with the
referral office.
Inactive – Select this checkbox to designate this referral source
as Inactive. Note: referrals cannot be deleted, only inactivated.
Notes – This area is used for additional reference information.
This field will not print anywhere.
Communication Preference – Select efax or email as the
preferred mode of communication with the current Referral.
Update Account Type Codes
Select System Tasks  Update Lists  Account Type. Select an
existing code to edit or select Add to create a new Account Type
code.
The purpose for Account Type Codes is to allow your office to
bill different insurance criteria required by your carriers on the
HCFA or UB04 forms and/or for grouping your carriers for
statistical reports.
User’s Guide – Patterson PTOS 5.6
Using PTOS  36
Account Type Code/ Name – Enter a two-to-five alphanumeric
character Account Type code. Enter the name of the account
type as you would like it to display on PTOS reports.
Place of Service (POS) – This field appears in Box 24B on the
HCFA form. This is a required field.
Co-Pay Amount – Enter the amount of the co-pay attached to this
Account Type.
Charge per day – Enter the maximum charge per day amount.
Ins Cap Amount – Enter the limit for those insurance carriers who
have specific limits or CAP. This field can be tracked in the
transaction screen and will warn you when the patient has
reached their CAP.
Accept Assignment – Use the drop-down menu to accept the
assignment.
Posting Note – Enter an account note that will display in the
patient’s transaction screen.
Patient Statement Notes – Enter a note that will display on the
patient’s statement.
CCI Dataset – Select the checkbox to use CCI dataset.
LCD Dataset – Select the checkbox to use LCD dataset.
The Following Boxes Are Filled Out On The HCFA Form –
These fields are for additional criteria insurance carriers may
require for additional information. Your office will be responsible
for knowing the insurance carrier’s requirements.
The user can print primary insurance information in boxes 11A-C
on secondary claims and box 9 has the option to be left blank.
User’s Guide – Patterson PTOS 5.6
Using PTOS  37
Primary Insurance:
Box 9 – Select the drop-down menu to use Fill out with other
insurance information or leave blank.
Box 11 – 11C – Select the drop-down menu to use Fill out with
primary information, Print ‘None’ in box, or leave blank.
Box 11D – Select Y for yes or N for no.
Secondary Insurance:
Box 9 – Select the drop-down menu to use Fill out with other
insurance information or leave blank.
Box 11 – 11C – Select the drop-down menu to use Fill out with
Secondary/other information, Fill out with primary information,
Print ‘None’ in box, or leave blank.
Box 11D – Select Y for yes or N for no.
Select the following checkboxes if desired:
Print Primary Care Physician in Box 17
HCFA Box 17A/UB04 Box 76 Qualifier – Enter a qualifier
number for insurance carriers.
Print UPIN in Box 17A – Use this option to print or not print UPIN
Leave Box 24J White Blank
Use Provider SSN (HCFA 25/UB04 5)
Print One Date Per Page
The Following Boxes Are Filled Out On The UB04 Form –
These fields are for additional criteria insurance carriers may
require for additional information. Your office will be responsible
for knowing the insurance carrier’s requirements.
Select from the following checkboxes if desired:
UB04 Print Entire Date Range in Box 6
Add Leading 0 to Rev Codes
UB04 VISIT Rev Code – Enter the UB04 Visit revenue code.
Print NPI in Box 56
Print Rev Code in Box 44 of UB04 Summary
User’s Guide – Patterson PTOS 5.6
Using PTOS  38
Print Modifier on HCFA/UB04 – Use the drop-down list to select
Y, N or leave Blank.
Employers
Under System Tasks  Update Lists  Employers, create and/or
edit Employer information. To search, enter % and select the
search icon.
The Employer number can be
up to seven characters
alphanumeric.
To enter a new Employer, select the Add icon or select F2. Enter
the Employer No, Employer Name, Address, City/State/Zip and
Phone. Select the Save icon to save.
Select the Inactive checkbox to render this Employer inactive.
Employers cannot be deleted.
Zip Codes
Under System Tasks | Update Lists | Zip Codes, create and/or
edit the city, state and zip information. To search, enter % and
select the search icon.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
To enter a new zip code, select the Add icon or select F2. Enter
the City, State and Zip. Select the Save icon to save. To delete a
zip code, select the desired entry and select the Delete icon. Zip
User’s Guide – Patterson PTOS 5.6
Using PTOS  39
Codes are preloaded with versions 4.5 and 5.0. (See eClaims
5010 Zip Code Requirement).
Lookup Table
The Lookup Table is located under System Tasks | Update
Lists | Lookup Tables. It is a database of all abbreviations used
in PTOS. Select the Add icon to add an additional code. Select
the Edit icon to edit an existing code. Select the Inactive
checkbox to inactivate an existing code.
The Lookup Table contains all of the abbreviation codes and their
descriptions for the following areas:

Clinical Discipline

Injury Area

Note Type

Referral Specialty

Revenue Code

Scheduling Resource Group

Scheduling Therapist Group

Signature Qualifier
Use the Inactive checkbox to render the selection unavailable.
Lookup options cannot be deleted.
Payment Types
To add, delete or edit Payment Types, go to System Tasks 
Update Lists  Payment Types.
User’s Guide – Patterson PTOS 5.6
Using PTOS  40
Payment Prompt numbers
refer to check numbers or
credit card numbers.
Select the Add icon or F2 to add a new Payment Type. Select
the Edit icon to edit an existing Payment Type. Select the Delete
icon to delete an existing Payment Type.
To enter a new Payment Type, enter a Description, Payment
Prompt and select the Currency Type. Select the checkbox
Display on Statement to include this information on the patient
statement.
Select the Inactive checkbox to render the selected currency type
inactive.
Adjustment Type
Select System Tasks  Update Lists  Adjustment Types
User’s Guide – Patterson PTOS 5.6
Using PTOS  41
To enter a new Adjustment code, select the Add icon or select
F2. Enter the Code and Description and select the Adjustment
Impact. Select the checkbox Default Type for Insurance
payments to automatically default the adjustment type when
making an insurance payment. Select the Inactive checkbox to
disable a selected adjustment.
Transaction History Legends
In System Tasks  Update Lists, select Transaction History
Legends to view and assign color-coding for the transactions. To
assign a color, select the color box associated with the
transaction. Select a Custom, Web or System to access a
broader spectrum of colors. Select OK to save changes.
Default colors by type:
User’s Guide – Patterson PTOS 5.6
Using PTOS  42

Blue = Charges

Green = Open Claims

Pink = Payments

Light Blue = Adjustment

Lavender = Billed

Red = Unapplied

Orange = Finance Charges

Turquoise = Modified

Gray = Voided Transaction
ICD9 Codes
Select System Tasks  Update Lists  ICD9 Codes. Use the
Search field to locate the desired code or select the Add icon to
enter a new code.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
Enter the ICD9 Code, Name and Injury Area. Select the Inactive
checkbox to disable the selected ICD9 code. ICD9 codes are preinstalled. NOTE: Asterisks denote required fields.
Update C.P.T. Codes
Select System Tasks  Update Lists  C.P.T. Codes and use the
Search field to locate an existing code or select the Add icon to
enter a new code. Selecting F2 will also add a code.
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Using PTOS  43
Enter the required fields for C.P.T. Code (up to ten digits), C.P.T.
Name and Charge Per Unit. Additional information fields are
available for:

Cost

Time

Allowed Amount

Modifier

Rev Code

Units
To inactivate an existing code, select the Inactive checkbox.
Select the checkboxes to apply the following options:

Display on Charge Ticket

Display on Additional Code Tab

Bill To Patient

Display on Superbill

Taxable Service

Count As Visit

Select the Fee History… button to view the history of
changes to the selected C.P.T. code including the date
changed and the User ID of the person who made the
changes.

Select the Copy button to copy the exact contents of another
CPT that already exists
o
Select the CPT*Code you wish to duplicate. Hit the
Copy button to enter a unique CPT*Code for the
duplicate CPT*Name, Charge Per Unit, etc. This
provides a shortcut for offices selling supplies, etc.
where they may want to have a similar description for a
set of codes. (ex: 90111 Bandage; 90111-2 Bandage
Small; 90111-3 Bandage Medium; 90111-4 Bandage
Large, etc).
C.P.T. Group
A C.P.T. Group is a collection of C.P.T. Codes that are often used
in conjunction. C.P.T. Groups are used to create ‘cascading
charges’ or ‘exploding codes’. To use C.P.T. Group codes, enter
the codes in the order of highest to lowest fee amount.
Select System Tasks  Update Lists  C.P.T. Groups use the
Search field to select an existing code to edit or select the Add
icon to enter a new group.
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Using PTOS  44
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
Enter a C.P.T. Group name and Description. Select from the
available checkbox options:

Inactive

Bill To Patient

Display on Superbill

Display on Charge Ticket

Display on Additional Codes Tab
Select the ‘x’ in the remove column to subtract a code from an
existing code group.
Fee Schedule
NOTE: Fee Schedules are optional.
Select System Tasks  Update Lists  Fee Schedule. Select the
Fee Schedule Names button to create a new Fee Schedule.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
User’s Guide – Patterson PTOS 5.6
Using PTOS  45
The following window appears.
Select the Add icon
to create a new fee schedule. Enter the
Fee Schedule Code and Fee Schedule Description. Select the
Save icon. Select the x to close the window.
In the Fee Schedule window, use the Fee Schedule drop-down
menu to select the desired Fee Schedule. Select the Discipline.
Enter the amounts of the Insurance Reimbursement Contract Pay
Schedule. Select Save.
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Using PTOS  46
Save As New
Select the Save as New button to create a new Fee Schedule
based upon an existing Fee Schedule. To use the Save as New
feature:
1. Select the Fee Schedule Names button to name the new
Fee Schedule.
2. Save the new Fee Schedule Name.
3. In the Fee Schedule window, select the existing Fee
Schedule you wish to copy.
4. Select the Save as New button
5. Using the drop-down list, select the Name, Discipline and
Effective From date.
6. Select Update
icon.
7. Select OK.
Edit an Existing Fee Schedule
To edit an existing Fee Schedule, use the drop-down menu to
select the desired Fee Schedule, Discipline and Effective From
date. Once the Fee Schedule has been selected, make the
necessary changes and save.
Show the Fee Schedule History
Select the Show Fee Schedule History checkbox to display the
history of changes to a selected Fee Schedule.
NOTE: Each C.P.T. Code’s information is displayed including
effective dates.
Show All
Select the Show All checkbox to display all active C.P.T. Codes
even if they are not currently attached to fee schedules.
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Using PTOS  47
Attaching Fee Schedules to Patients
Attach the Fee Schedule to a patient in the Patient Editor.
Select Patient Editor and enter the desired patient. Select Edit.
Use the drop-down arrow to select the Fee Schedule.
The following is an example of the Fee Schedule in Patient Editor.
The Fee Schedule amount will display on the Enter Charges
screen under Allow. Amt.
The following is an example of the Fee Schedule in the Enter
Charges screen.
NOTE: The Fee Schedule attached to an Insurance Company
overrides the Fee Schedule attached to the Patient Case.
Attaching Fee Schedules to Insurance
Companies
Attach the Fee Schedule to an insurance company in the
Insurance Company window. Select System Tasks  Update
Lists  Insurance Company. Select the Insurance Company
desired. Use the Fee Schedule drop-down list to select a Fee
Schedule from the available options.
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Using PTOS  48
LCD Datasets
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
Use your Local Coverage Determinations (LCD) Datasets to
ensure that C.P.T. Codes and Diagnosis codes are payable by
insurance when billed together. A warning will appear when the
conflicts are present.
For more information on LCD
data and CCI data, visit
www.cms.gov/mcd.
To setup your LCD datasets, go to System Tasks  Update Lists
 LCD Dataset. In the LCD screen, select Add to setup a new list.
Enter the Name of the dataset and any comments required.
Select Save.
Using LCD data files
LCD data is frequently updated and made available to you by the
Center for Medicare and Medicaid Services. Creating a file to use
with PTOS is a manual process and will require you to create a
spreadsheet using this information and keeping it updated.
To add a LCD data file that you have created, select the Import
LCD Dataset File button. Use the Browse window to locate your
LCD data file. Locate the file and save.
Manually Enter LCD Data
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Using PTOS  49
To manually enter conflicting codes into the LCD dataset, select
the LCD Data button. In the LCD Data window, select Add to
enter the allowed LCD and Diagnostic codes. Select Save to
save them.
CCI Datasets
CCI Datasets are set up to prevent you from using conflicting
C.P.T. codes that should not be billed together. To setup your
CCI datasets, go to System Tasks  Update Lists  CCI Dataset.
In the CCI screen, select Add to setup a new list. Enter the Name
of the dataset and any comments required. Select Save.
Import CCI Data
CCI data is made available to your office by the Centers for
Medicare and Medicaid Services. A free excel file is available for
download and can be imported into PTOS. The www.ntis.gov is a
government approved website that also offers these edits for
download.
To add a CCI data file, select the Import CCI Dataset File button.
Use the Browse window to locate the CCI file that you have
received from the www.cms.gov website. Locate the file and
save.
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Using PTOS  50
Manually Enter CCI Data
The Modifier options are:
1 – Allowed
0 – Not Allowed for codes
to be billed together.
To add CCI codes individually, select the CCI Data button. In the
CCI Data window, select Add to enter C.P.T. Codes, C.P.T. Code
2, Effective Date and Modifier. Select Save.
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Using PTOS  51
Scheduling
Scheduler Setup
The Scheduling Admin area allows you to customize the setup
and appearance of the schedule.
Resources
In Scheduling | Scheduling Admin | Resources you can create
additional pieces of equipment or rooms in which to schedule your
patients. These items will appear on the schedule in addition to
your facility’s therapists.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
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Scheduling  52
You can add to the list of available resources or you can edit the
existing resources in the list. Another option available is the
multiple bookings option. If the resource can be used by more
than one patient at a time, the Allow Multiple Bookings option
can be checked and then the Max Allowed area can be set.
Enter the numerical value for the Sort Order. If it is a resource
you are not going to use, the Inactive checkbox can be checked
resulting in the resource being removed from the schedule.
Appointment Status
In Scheduling | Scheduling Admin | Appointment Status you
can customize the colors for various appointments and block hold
statuses.
Appointment / Block Hold Type
In Scheduling | Scheduling Admin | Appointment / Block Hold
Type you can create and customize the various types of
appointment and block hold types for your facility.
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Scheduling  53
You can create new or edit the existing Appointment and Block
Hold Types. The option to assign icons to these different types is
also available. Select the Browse Icon button if you wish to see
the icons that come installed. If you wish to use additional icons,
the ability to import more icons is available. They must be the .ico
format. If there are any types you will not be using, the option to
inactivate is available.
Appointment Reminder Email Template
In Scheduling | Scheduling Admin | Appointment Reminder
Email Template you can customize an email message that can
be sent to your patients to remind them of upcoming
appointments.
This template is completely customizable. This message can be
edited to fit the needs of your facility. The only areas that should
not be edited are the <Name>, <sdate> and <stime>. These are
User’s Guide – Patterson PTOS 5.6
Scheduling  54
programming items that populate the patient’s information into the
message.
Scheduling an Appointment
Scheduling a Single Appointment
To schedule a single appointment, open the schedule and either
double-click or right-click on the area in which you wish to
schedule the appointment and select New Appointment.
You can create an
appointment using Menu 
Scheduling  New
Appointment.
The New Appointment screen will open. First you will need to
select the patient you wish to schedule. To do this in the
Patient Name area you can type in the patient’s last name, or
you can enter % to open up a list of all of your patients. The Appt
Type and Treating Therapist must be filled out in the top portion
of this screen.
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Scheduling  55
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
The bottom half of the screen allows you to set the Appt Date,
Start Time, and End Time. The Duration will adjust depending
on the Start and End Time of the appointment. Once all the
information is entered, click on the Save icon in the upper lefthand corner to save the appointment and add it to the schedule.
Scheduling Multiple Appointments
To schedule multiple appointments, open the schedule and either
double-click or right-click on the area in which you wish to
schedule the initial appointment and select New Appointment.
Repeat the steps above to fill out the top portion of this screen.
1. Select the Multiple Appointments tab, enter the From
Date/To Date and Start Time/End Time. The Duration
will adjust depending on the Start and End Time of the
appointments.
2. In the Frequency area, there are three options:
User’s Guide – Patterson PTOS 5.6

Daily – If the patient’s appointments are every day
of the week, select Daily.

Weekly – If the patient’s appointments are on
certain days of the week, select Weekly and then
choose the appropriate days.
Scheduling  56

Selected – If the patient’s appointments are on
random days, select and then click on the days the
appointments need to be scheduled. The dates will
populate on the right side of the screen.
3. Click the Save icon in the upper left-hand corner to save
the appointments and add them to the schedule.
Additional Therapists
To schedule additional therapists to an appointment, select the
Additional Therapists tab.
Select the Add Therapist button to schedule an additional
therapist to this appointment. Select the Delete Therapist button
to remove an added therapist from the existing appointment.
Additional Resources
To schedule additional resources to an appointment, select the
Additional Resources tab.
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Scheduling  57
Select the Add Resources button to schedule an additional
resource to this appointment. Select the Delete Resources
button to remove an added resource from the existing
appointment.
New Appointment (from Waitlist)
In the Schedule, use the right-click menu to schedule a new
appointment from the Waitlist. The Waitlist appears. Select the
checkbox associated with the desired appointment and select the
Add New Appointment button.
Scheduling Blocks
Creating a Single Block
To create a single block, select Scheduling  New Block Hold or
open the schedule and right-click on the area you wish to place
the block and select new Block Hold.
The New Block Hold screen will open. The Block Hold Type,
Facility and Resource areas must be filled in. You can also add a
note to the block.
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Scheduling  58
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
* – Field must be completed.
The bottom half of the screen allows you to set the Date, Start
Time and End Time. The Duration will adjust depending on the
Start and End Time of the block. Once all the information is
entered, click on the Save icon in the upper left-hand corner to
save the block and add it to the schedule.
Creating Multiple Blocks
To create multiple blocks, open the schedule and right-click on the
area in which you wish to schedule the initial block. Repeat the
steps above to fill out the top portion of this screen and select
New Block Hold.
Select the Multiple Block Holds tab, enter the From Date/To
Date and Start Time/End Time. The Duration will adjust
depending on the Start and End Time of the block.
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Scheduling  59
In the Frequency area, there are three options:

Daily – If the Blocks are every day of the week, select
Daily.

Weekly – If the Blocks are on certain days of the week,
select Weekly and then choose the appropriate days.

Selected – If the Blocks are on random days, select and
then click on the days the blocks need to be scheduled.
The dates will populate on the right side of the screen.
Additional Therapists
To add additional therapists to a Block Hold, select the Additional
Therapist tab.
Select the Add Therapist button to schedule an additional
therapist to this appointment. Select the Delete Therapist button
to remove an added therapist from the existing appointment.
Additional Resources
To add additional therapists to a Block Hold, select the Additional
Resources tab.
Select the Add Resources button to schedule an additional
therapist to this appointment. Select the Delete Resources
button to remove an added therapist from the existing
appointment.
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Scheduling  60
Delete Block Hold
To delete an existing Block Hold, right-click on the Block and
select Delete Block Hold. The following message appears.
Select Yes to delete the block. Select No to close without
deleting.
Editing Appointments
You can edit any scheduled appointment by simply double-clicking
the appointment. It will then open up the appointment screen.
Checking In an Appointment
When a patient arrives for his or her appointment, you have the
option to check that patient in on the schedule. This can be done
by right-clicking on the appointment, then selecting Check-In from
the menu.
When this option is chosen, the display color of the appointment
will indicate the patient has arrived at the office and is ready for
the appointment. The Check-In feature also allows you to collect
the patient’s co-pay (if applicable).
Cancelling an Appointment
Once an appointment has been scheduled, you have the option of
cancelling the appointment. This can be done by right-clicking on
the appointment, then selecting cancel from the menu.
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Scheduling  61
After selecting cancel, you will have the option to make a
comment on why the appointment was cancelled. On the bottom
of this screen there will be a list of the patient’s upcoming
appointments so you can remind the patient of his or her next
appointment. The option to view the waitlist is also here. This will
allow you to see if there are any appointments in the waitlist that
you can call on to fill your schedule.
No-Show Appointments
If a patient does not show up for their appointment, you can mark
the appointment as a No-Show. This can be done by rightclicking on the appointment, then selecting No-Show from the
menu.
Like cancelled appointments, when No-Show is chosen, you will
have the option to make a comment about the No-Show
appointment and view the waitlist if necessary.
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Scheduling  62
Reschedule
Reschedule an appointment, select the existing appointment.
From the right-click menu, select Reschedule. Select the desired
appointment time and date. Appointments and Blocks can also be
rescheduled by dragging or cutting and pasting.
Voiding an Appointment
If an appointment is created for the wrong patient, it can be voided
from the schedule. This can be done by right-clicking on the
appointment, then selecting Appointment Void from the menu.
The Appointment Status window appears. Enter a Comment to
this appointment void, if applicable.
Select the View Waitlist checkbox to launch the Waitlist after
voiding. This will allow you to see if there are any appointments in
the waitlist that you can call on to fill your schedule.
Select Ok to void this appointment. Select Cancel to exit without
voiding.
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Scheduling  63
Additional Right-Click Options
Collect Co-Pay
If the patient’s co-pay was not collected at the time of Check-In, it
can be collected at a later time using the Collect Co-Pay. To
access the Collect Co-Pay option, right-click on the appointment
and choose Collect Co-Pay option from the menu. The following
window appears.
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Scheduling  64
In the Co-Pay window, select the applicable co-pay. Use the
drop-down menu to select the Payment Type and Facility ID.
Select Collect Co-Pay to complete the transaction. Select
Cancel to exit without collecting.
Select the Co-Pay History button to view a list of past co-pay
payments for the selected patient.
Enter Charges
Based upon your individual
config settings, the Enter
Charges window may appear.
The Enter Charges feature allows you to complete a charge ticket
for this appointment. To access the Enter Charges feature, rightclick on the appointment and choose Enter Charges from the
menu.
This will open the Charge Ticket area. Simply select the
appropriate charges for this appointment and then click OK to
complete the Charge Ticket.
Select Cancel to exit without applying a Charge.
Select the Audit Charges button to check for warnings that have
been attached to the selected C.P.T. code. Select the checkbox
Filter C.P.T. Codes to filter out any addition codes from the list.
To sort this list by column headings, select the name of the
column. All columns can be sorted.
Select the Filter C.P.T. Codes checkbox to remove the C.P.T.
Codes from the list.
Select the Additional Codes tab to access your office’s additional
non-billable codes.
To enter a charge, select the corresponding checkbox in the
Select column. Select OK.
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Scheduling  65
Note Complete
The Note Complete feature allows for the Scheduling and
Documentation modules to communicate. To link an existing
note to a new appointment, right-click on the appointment and
select, Note Complete. This will associate the note with the
appointment in the Worklist.
Copy
Use this option to copy the selected appointment.
Cut
Use this option to cut the selected appointment.
Paste
Use this option to paste the selected appointment onto the
schedule.
Patient Editor
The Patient Editor feature allows access to the patient
information without ever leaving the schedule.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
Print Appointment Card
This option can be used to print a full-page appointment card for
your patient. The Appointment Card includes the Appointment
Date, Facility ID, Start Time, Appointment Type as well as the
Therapist he or she will be seeing.
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Scheduling  66
Print Superbill
This option allows your office to print off a checklist including all
the charges that may be billed to a patient. This can be filled out
and then that information can be used to assist in filling out a
Charge Ticket for your patient’s appointment.
Schedule Calendar View
Schedule Views
There are different schedule views that can be used for the
schedule. The Daily View shows all appointments at your facility
for the selected day.
Further filter the view by Facility, Therapist Group and
Resource Group.
The Weekly View allows you to see the weekly schedule for a
single therapist or resource at your facility.
Show CXL/NS Appointments
This checkbox allows you to control whether you would like to see
appointments that have been marked as cancelled or no-show
appointments. This option can be toggled on/off at any time.
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Scheduling  67
Send Email Reminder
This option allows you to send appointment reminders via email.
If this option is selected, an email information box will appear
showing the Total Appointments, how many have email
addresses set up and the amount of emails to be sent now. You
will then have an option to send out the reminders.
Print Preview
This option allows you to preview the schedule prior to printing. If
you need a hard copy of the schedule, you can print it from this
area. This option is only available in Calendar view. To access
print preview, go to Scheduler, and click the Print Preview button
in the upper right of the screen. Select the printer to be used.
Click Ok. Once the printer is chosen, the preview is created.
Print in Color
Selecting the ‘Print in color’ button in the upper right of the screen, will
preview and print the schedule in color, otherwise it will preview and print
in gray scale. The box is defaulted as 'unchecked'. Once the box is
selected, the system will retain the selection going forward.
Schedule Appointments View
Select the Appointments tab to view the schedule by
appointment.
In the Appointments view, select to view appointments
Appointment Search.
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Scheduling  68
The Appointment Search View allows you to see the available
time for your therapists. Further filter this view by Facility,
Therapist and Resource.
Enter the Appt Duration time and select the Time of Day to
further narrow the search for an available appointment time.
Select the Show Block/Holds checkbox to include that
information in the Appointment Search.
Transfer Appointment
Under Scheduling  Transfer Appointment, move appointments
between rooms.
Select the Source Therapist, Start Date, End Date and
Destination Therapist. Select the Refresh button. Select an
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Scheduling  69
appointment using the checkbox Select or select the Select All
checkbox. Select the Transfer button to move appointments.
Waitlist
To schedule an appointment using the Waitlist, select
Scheduling  Waitlist.
In the Waitlist, narrow your list by selecting the Facility, Time of
Day, Therapist, Resource, Appt Type and Waitlist Dates. To
schedule a Waitlist patient, check the Select checkbox and select
Add Appointment. To remove a patient from the Waitlist, check
the select box and select Remove from Waitlist. Select Close to
exit.
Appointment / Block Void
To use the Appointment / Block Void, select Scheduling 
Appointment / Block Void. Enter a patient and select Enter.
Select the desired appointment and select Void. In the Multiple
Status Comment, enter a comment if desired. Select OK to void
the appointment.
The following screen appears.
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Scheduling  70
Select OK.
Voiding Blocks
To Void a Block, leave the Patient Name and Patient Acct# fields
blank. Select the Therapist desired or leave as Any Therapist.
Select the Resource, Start Date and End Date desired. Select
Fetch to retrieve data. Select the desired Block and select Void.
Enter a comment (optional) and select OK to Void.
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Scheduling  71
Documentation
Template Admin
Use the Template Admin to create customized correspondence.
Go to Documentation | Template Admin. Select the headings
on the Information tree to open additional screens. The following
is example of the Patient Questionnaire template.
In the Note Type, select from the available options in the dropdown list.
Header
Header information includes the following items:
Patient
Acct #
SSN
Phone
Phone/Fax
Therapist
Date of Service
Referred By
PCP
Diagnosis
Injured Date
Initial Evaluation Date
Total Visits/CXL/NS
User’s Guide – Patterson PTOS 5.6
DOB
Insurance
Authorization/Claim #
Documentation  72
Additional Options
Select the Link to Appointment checkbox to tie the selected
template to patient appointments.
Select the Close Note Charge Ticket to display the Charge
Ticket when the selected note is closed
Select the Inactive checkbox to inactivate the selected note.
Comments are not required for a printout.
Edit Template
To edit an existing template, select the Edit icon. This will allow
you to make the following changes:
Paragraph Status
Use the drop-down menu to select the Paragraph Status.
User’s Guide – Patterson PTOS 5.6

Hide Paragraph – Select this option to hide the selected
paragraph.

Show Paragraph – Select this option to show the selected
paragraph.

Include by Default – Select this option to include the
selected paragraph by default.

Required to close Note – Use this option to require
paragraph completion prior to closing.
Documentation  73
Show/Hide Detail
To remove or display individual lines from paragraph information,
select the Show/Hide Detail button.
In the Show/Hide Paragraph Details window, deselect the Show
checkbox to hide the line item from the paragraph. Select OK to
save.
Copy from Note
To include information from other Notes, select Copy from Note
and select the note from which to pull the information.
Pick Lists
To access Pick Lists, select Documentation  Change Pick List.
The other is to right-click in the yellow areas of patient chart. Use
Pick Lists to enter pre-created information throughout the note.
1. Right-click on the yellow field and a Pick List appears.
This example is a single select pick list indicating that only
one of the items can be selected from the list.
2. Once an item is selected it will be entered into the note.
In addition to single select pick lists, there are multiple select pick
lists, which allow you to choose one or more items to be entered
into the note. In the yellow highlighted areas, it is not a
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Documentation  74
requirement to use the pick lists, the option to free form type is
available.
Patient Chart
The first step to creating notes is to open up a patient’s chart. You
can access patients’ charts by selecting Patient Chart at the top
of your screen or by going to Documentation  Patient Chart.
Select the desired patient from the Patient Search window.
Creating a New Note
To create a new note, select the Add Note icon or select the F2
key.
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Documentation  75
Choose the Note Type you
wish to create from the
dropdown menu. Verify that
the Date of Service is correct
and select OK to create the
note. For this example, we
will use the Progress/Daily
Notes.
You can also double-click on
a paragraph to remove it.
To create a new note based
upon existing information,
select Copy from existing
note. Use the drop-down to
select the desired note.
Select the Date of Service
and select OK to continue.
Add attachments to a note by
selecting the Attachments
tab. Select the Browse button
to locate the file. Enter a
Description and date if
necessary. Select OK to
attach the file to the current
note.
The Initial Evaluation note will now populate the screen. Along
the left side of your screen is a display of the different paragraphs
that can be included in the Initial Evaluation note. The paragraphs
displayed in purple are the ones that are included in the Initial
Evaluation note by default. The option to include the gray
paragraphs is available by right-clicking on the paragraph and
selecting Add Paragraph or double-clicking the paragraph. In
addition, any paragraph that is included by default can be
removed by right-clicking on the paragraph and select Remove
Paragraph.
The Header of the note will be populated with the patient’s
information already entered into the system. This information can
be edited here if needed.
Saving a Note
Notes may be automatically saved as you add to or make
changes to a note.
Edit and/or enhance the pre-written narratives in PTOS notes. In
Documentation | Template Admin, select the Note Type from
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Documentation  76
the drop-down menu. The following paragraph templates can be
modified:

Short/Long Term Goals

Special Tests

Problem Lists

Treatment Plan
Edit Paragraph
Details
In Template Admin, select one of the editable Note Types from
drop-down list. The editable Note Types are:

Patient Questionnaire

Initial Evaluation

Re-Evaluation

Progress/Daily Notes

Cancel/No-Show

Discharge Summary

Discharge Summary – Brief

Flow Sheet

Physician Letter

PTPN Initial Evaluation Report

PTPN Initial Evaluation Letter

PTPN Progress/Daily Notes
In the Paragraph Description list, select the desired description.
Select the Edit (F3) icon to place the template in Edit mode. Next,
select the Edit Paragraph Details button. The following window
appears:
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Documentation  77
In the Edit Paragraph Details window, select the name of the
detail that you wish to edit.
Select the Show checkbox to display the detail on your template.
Deselect the Show checkbox to hide the detail.
The last changes made to the
Paragraph Details will become
the default.
Ten additional blank lines are also available at the bottom of each
narrative. In the Edit Paragraph Details, select the Show
checkbox next to the blank lines to add them to the templates.
Select OK to save your changes.
Comparing Initial Evaluation with Re-Evaluation
PTOS Documentation has the ability to compare Initial
Evaluations and Re-Evaluation on a single note. You have the
ability to compare up to three notes on a single page (i.e. Initial
Evaluation, and two Re-Evaluations). Once the Initial Evaluation
has been created, a new note needs to be created. Choose ReEvaluation as the Note Type for the new note. After clicking OK,
the option to compare the note to an existing note becomes
available.
Choose the note(s) that you wish to compare and then click OK.
The new document comparing the notes will now populate your
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Documentation  78
screen. Fill in the appropriate information in the Re-Evaluation
column and save the document.
Note History
The Note History allows you to view all existing notes for this
patient. This includes all open, closed and voided notes and
attachments for the individual patient.
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
Open Note Options
Right-clicking on a note in the Note History area opens up a
menu of options pertaining to the individual note.
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Documentation  79
Preview
This option opens up a print preview of the selected note. This
allows you to see what the note will look like when printed.
Print
This option prints the selected note.
Editing Using PTOS Editor
This option opens the selected note so additions/changes can be
made. You can also double-click the note in the Note History to
open it in the PTOS Editor.
Sign
This option allows for several actions to take place. When
selected, the first screen that will appear is the Charge Ticket
screen. The ticket can be filled out at this time or you can use
cancel if you wish to fill it out at a later time. The next screen is
the Sign Note screen. The first step is selecting the appropriate
Date of Service and Therapist. Next, if you wish to close the
note, the Primary Therapist box will need to be checked. The
selected therapist will then be required to type in his/her
password.
Select OK and the note will now be signed and closed. Once a
note is closed, it will now move into the closed category under the
Note History.
Void
If a note is mistakenly created, the option to Void the note is
available. All voided notes stay in the patient chart but cannot be
edited once they have been voided. Right-click on voided notes to
print or preview.
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Documentation  80
Charge Ticket
This will open the Charge Ticket screen. Simply select the
appropriate charges for this note and then select OK to complete
the Charge Ticket.
Edit Using Microsoft Word
Use this option to edit a note outside of PTOS. Once a note has
been edited in MS Word, it can no longer be edited in the PTOS
Chart Area.
Closed Note Options
Fax/Email
This option can be used if you are set up with an electronic fax
company or are using a MAPI (Messaging Application
Programming Interface) compliant email program.
Re-Open
This option allows the note to be opened and edited. It is only
available until midnight of the day the note was signed.
Add Addendum
If a note is closed and it can no longer be reopened, information
can be added to the note using the Add Addendum feature. It
opens a free-form text field where additional notes can be entered.
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Documentation  81
Link Note to Appointment
If you have purchased both the Scheduling and Documentation
modules, you have the ability to link notes to appointments. Once
an appointment is on the schedule, you have the ability to link a
note from the Patient Chart to that appointment.
Review
This area allows you to compare paragraphs from multiple notes.
For example, if there are three Daily/Progress Notes for a
patient, you can select which paragraph from those notes you
would like to compare. Choose which notes you would like to
compare by checking the box on the left, then choose the
paragraph you would like to compare at the bottom.
The paragraphs will then be compared on a single, printable page.
Facility Logo
Under Special Tasks | Add/Update Client Logo you can
customize notes by adding your facility’s logo. In this screen you
can Add/Update or remove a logo from your notes. Select the
Add/Update Client Logo button to browse to the desired image.
User’s Guide – Patterson PTOS 5.6
Documentation  82
Note: Logo size must be
120 x 120 pixels.
User’s Guide – Patterson PTOS 5.6
Documentation  83
Billing
Transactions
NOTE: If you are still using PTOS Billing 3.5, please refer to
your PTOS 3.5 manual for information pertaining to the Billing
module and its functions.
PTOS 5.0 Billing handles all transactions for patients, such as
charges, payments, adjustments, outstanding balances, and other
important financial information.
Transactions entries affect an account balance.
Enter Charges
1. Select Billing | Enter Charges in the PTOS Menu Bar.
See the Glossary of Terms
located at the back of this
manual for more information
on terminology.
The boxes at the top of the case display read only information that
defaults from Patient Editor for the Patient name displayed in the
posting line. The upper portion of the window contains numerous
fields:
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Billing  84

Patient # – The Patient ID number

Name – Patient Name

Case # – Case Number

Authorized (date) – Authorized dates for service

Visits – Number of visits completed

Allowed – Number of visits authorized

Remaining – The difference between Visits and Allowed

Discipline – The required discipline

Acct. Type – The patient account type

Post Note – Any available notes

Charge Limit – The authorized charge amount per visit

Charge per Day – The amount of charge authorized per
day

Primary DX, DX-2, DX-3, DX4 – Diagnosis codes
applicable
Charges are entered in this order:

Date – The Date automatically defaults to the login date,
but the user can edit the date. Once the date is edited,
subsequent lines default to the new date. A date in the
future can also be entered. (This field is required)

Patient Name – When accessed from Patient Editor or
Scheduler, the current patient appears automatically. If
accessed anywhere else in the system, the field is blank
and Patient information must be entered manually. (This
field is required)
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
In the posting line, enter the first few letters of the patient’s
last name, or % in the Patient Name field and select the
Enter or Tab key to enter the Patient Search window to
select a patient. Select the X and proceed as above to
display the Patient Search window.
A Grand Total of All Charges for all patients in this
charge window appears at the top of the window.
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Billing  85
Entering Billing information
C.P.T. Code – Enter a C.P.T. code into the patient’s record by any
of these three ways:
1. Type the C.P.T. code into the C.P.T. code field.
2. To find the closest match to the code you want, activate
the C.P.T. Code Search window by typing the first few
characters into the field and pressing Enter.
3. Type the percent (%) sign into the field to bring up the
C.P.T. Code Search window.
Units – Enter the number of units. Units will default to this
window from C.P.T. Code setup. This field is editable.
Chg Amt – This number is generated from the C.P.T. code or Fee
Schedule and cannot be edited.
Allow Amt – This number is generated from the C.P.T. code or
Fee Schedule and cannot be edited.
Modifier – The default for this field is from C.P.T. Code Setup. It
can also default from Fee Schedule, which would override what
was entered during C.P.T. Code Setup. The limit is 4 modifiers.
Modifiers can be edited from the Billing window.
Description – Defaulted from C.P.T. Code Setup or from the
ICODE entry.
If no Therapist is set up, choose
a therapist by selecting the dropdown arrow.
PT – Click on the drop-down arrow to select the PT who provided
the service. If the patient has an Assigned Therapist, that name
will default into this field. A Therapist set in an Appointment has
precedence over an assigned therapist.
DX – Select which diagnosis is appropriate for this service. The
default DX set in Patient Editor displays and can be edited. A
maximum of four (4) DXs can be displayed.
Co-pay – Defaults from what was entered in the Patient Editor.
If Co-pay was entered in Scheduler, it overrides any other co-pay
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Billing  86
amounts entered elsewhere in the system. If co-pay is not
entered through Scheduler, then co-pay defaults from the Patient
Editor Bill Tab. If the Bill Tab is blank, then it would default as 0
(zero) on the enter charges. Co-pay can be manually entered but
defaults to codes that are marked to affect visits.
Visit – The default is checked anytime there is not an existing
Visit marked for each DOS for a patient unless the C.P.T. code
was not designated to count as a visit in code setup. A visit is not
required to post charges. If you manually change the Visit box,
the system will not override this value unless the patient date of
service is changed.
Bill To – Designates which party you are billing for the charges
about to be entered. It defaults to primary insurance, unless
something different is specified in the C.P.T. code, which would
then take precedence. It can be modified. If no insurance is listed
for the patient, it should default to Bill to Patient Responsibility.
Click on the drop-down arrow to select who will receive the bill for
services provided to the patient.
Facility – Click on the drop-down arrow to select the physical
office or treatment center where medical services were provided
to the patient. The default for this field is from Scheduler. If
nothing is set in Scheduler, then use the assigned facility for the
selected case in Patient Editor. If the assigned Facility field is
blank, it should default to the Primary Facility that was assigned
in Patient Editor.
POS (Place of Service) – Defaults from the HCFA/UB04 Tab in
Patient Editor. If the Patient Editor POS is blank, then the POS
during charge entry will default from the Account Type, if there is
one attached.
Rev – Can be assigned if one applies to this charge. The default
is what was set in C.P.T. Code Setup or Fee Schedule. If it
remains blank, nothing is selected.
ICODE – An ICODE can be used in place of a C.P.T. code by
typing an ‘I’ in the C.P.T. code field. An ICODE Charges box
displays. ICODES are used as ‘placeholders’ for codes that are
not currently available in the system. ICODE will default to Y
(Yes) as a Visit. Deselect if you would like to remove and count
as N (No).
ICode checkbox – Box is automatically checked to designate
when an ICODE is created. It is defaulted to be check marked
when an ICODE is used in the C.P.T. Code box. This box cannot
be modified.
Charges entered from the Enter Charges window are
automatically approved. Charges entered from Documentation
and/or Scheduling through the Charge Ticket will remain
Unapproved. User can edit and then Approve these charges.
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Billing  87
Boxes across mid section of page are separated into three groups
that define the following information for the chosen patient:
Group 1 — Previous Patient Balance (excludes
current charges)
* Case Balance: Same as Balance on Transaction
Summary. Case Balance is the total balance per case.
Current charge entry is not included in this total.
* Ins. Balance: Total of Primary/Secondary and Tertiary
balances from Transaction Summary screen or calculated
as the Charge Amount – Deductible - Co-pay – CoInsurance.
* Patient Balance: Should correlate with Patient Balance on
Transaction Summary screen; calculated as the Co-pay +
Co-Insurance (minus current charge entry) + Deductible.
Group 2 — Case Information (includes current
charges)
* Last Visit: Date of last charge on Transaction Hx screen.
* Last Code: last procedure from the last date of charge
posted in Transaction Hx screen.
* Fee Schedule: Pulls first from Patient Editor (Patient
Case) and then from Insurance Company setup. This will
also reflect any changes made manually on the current
charge.
* Max. Units per Day: Data obtained from Patient
Editor/Billing tab.
Group 3 — Today’s Charges (includes current
charges)
User’s Guide – Patterson PTOS 5.6

Total Patient Portion (Co-pay + Co-Insurance +
Deductible).

Total Charges This Patient – Total of all charges posted
for this patient.
Billing  88
Other Enter Charges Features

Cogwheel icon: If charges are already entered, these
options are immediately available: Patient Editor, Charge
Ticket, and Last Visit.

Patient Editor: The main location in PTOS 5.0 where you
can Add, Edit and/or View patient data in the system.

Charge Ticket: Select this option to take you directly to
the Charge Ticket to enter charges.

Last Visit: A quick way to post recurrent charges to patient
cases(s). If the patient has been treated previously at this
facility, the information from the last visit defaults. This
feature is disabled on new patients.
Charge Ticket
A Charge Ticket can be accessed from Scheduling and/or
Documentation with the same functionality in all areas. In
Scheduling, right-click on an appointment and select Enter
Charges.
The Charge Ticket allows you to:

Select charges for a specific Date of Service

Audit Charges

Filter Procedure Codes for Fee Schedule
Once you select charges from the Charge Ticket and click Ok,
the charges are held as Unapproved.
When a Charge Ticket or Superbill is displayed for a particular
patient, it is more efficient to show only the Fee Schedule codes
User’s Guide – Patterson PTOS 5.6
Billing  89
that apply to that payer. If there are Fee Schedule codes, the
default will be marked to filter; otherwise, all codes will show.
At the top of the Charge Ticket, a non-editable date field displays
today’s date.
A separate area on the Charge Ticket includes all codes marked
specifically to include in this additional area (per C.P.T. CODE
setup. Codes displaying on the main area of the Charge Ticket
will be those marked to display on the main area of the Charge
Ticket per C.P.T. CODE setup.)
Appointment Warning Messages
You should get Warning Messages in Enter Charges and
Charge Ticket under the following circumstances:

The date of the proposed service is after the Authorized
Expiration Date for the Patient/Case(s).

If the number of charges entered and marked as visits for
the Patient/Case(s) exceeds the authorized Visit limit for
the Patient/Case(s).

Max number of Units is exceeded.

Charge per day is exceeded.

Charge Limit is exceeded.
Additional warnings that can be set include:

Charge limit warning based on Charged amount or Allowed

Config Parameter to be warned when you are within a
$XXX.XX specified amount of the limit.
Charge Limit Warning
Charge limits will automatically reset according to the effective
date entered for the period. To access Charge Limit, go to
Patient Editor | Bill tab. It is located in the upper right hand of
the screen.
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Billing  90
Payments/Adjustments
Keyboard Shortcuts
F2 – Use this key to Add a new
item in a list.
F3 – Use this key to Edit an
existing item in a list.
F5 – Use this key to search an
existing list.
% – Use this key in a search
field to open the entire list of
options.
Account Payment
To make Account Payments, select Billing  Payments /
Adjustments. Toggle between Account Payments, Insurance
Payments and Adjustments using the tabs on the left side of the
window.
In the Payment Information section, select the Payment Date if
not already apparent. Select the Facility. Use the Payment
Type drop-down list to select the type of payment being made.
Enter the Check/Bank/Authorization number pertaining to the
payment type. Enter the Amount of the payment. The Account
Type appears by default.
To apply the payment to Unapplied Payments, select the
Unapplied Payments drop arrow and select the transaction.
Enter a Comment if desired.
Select the checkbox Print Payment Receipt to create a receipt
for this payment.
Select Automatic Distribution or Manual Distribution to
distribute payment. Selecting Manual Distribution allows you to
enter the amounts to the desired transactions. Automatic
Distribution pays to charges with co-pay owed first and then to
the oldest Patient balance.
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Billing  91
Insurance Payments
To make Insurance Payments, select Billing  Payment /
Adjustments. Toggle between Account Payments, Insurance
Payments and Adjustments using the tabs on the left side of the
window.
Select the Insurance Payment tab to make Insurance payments.
In the Payment Information area, use the drop-down list to select
the Payment Date. Select the desired Facility. Review the
Account Type and select the Payment Type. Enter the Amount
of the payment and make any necessary comments. Mark Final
Payment if applicable. Select the Print Payment Receipt to
create a receipt.
Select Automatic Distribution or Manual Distribution to
disperse payment. Manual Distribution allows you to enter the
payments and amounts as you like.
In the Open Claims area, sort by the following columns:
Create Date
Claim Notes
Insurance
Patients
Name
Claim Amt.
Exp. Ins.
Adj. Amt
Adj Details
Ins. Pd
Ins. Type
Select the Edit Filter hyperlink to filter and narrow the payment
history by a specific date range. Use the drop-down arrows to
select the filter dates and select Apply Filter. To return the view
to show all transactions, select Reset Filter.
Payment information appears at the bottom of this screen.
Posting Payments-Multiple Users
Multi-User functionality provided for users posting payments
simultaneously in various payment windows. Multiple users can
User’s Guide – Patterson PTOS 5.6
Billing  92
post payments at the same time. The user may get a warning if
trying to post something at the exact same time as another user.
The system will stop one of them.
Adjustments
To make Adjustments, select Billing  Payments / Adjustments.
Toggle between those options using the tabs on the side of the
window.
Select the Adjustment Tab to make adjustments to a patient’s
account. In the Adjustment Information area, use the dropdown list to select the Adj. Date. Select the Adj. Type and review
the Acct. Type. Select the desired Facility. Select either Credit
Adjustment or Debit Adjustment. Enter any applicable
comments in the Comments field. Enter the Amount of the
payment.
Select Automatic Distribution or Manual Distribution to
disperse payment. Manual Distribution allows you to enter the
payments and amounts as you like.
Unapplied Payments are payments or adjustments that have been
made but not attached to transactions.
Default Adjustment Group and Reason Code
The default Adjustment Group Code and Reason Code will now
default when using the Auto Adjust feature in Config Parameters.
1) To set the Auto Adjust feature go to System Tasks |
Supervisor | Config Parameters. On the upper righthand-side select Billing. In the lower table select Billing |
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Billing  93
Auto Adjust | Yes. Select Edit to change the appropriate
value of Yes or No.
2) To set the default Adjustment Group Code and Reason
Code, go to Billing | Insurance Billing | eClaims Setup
tab.
The eClaims Provider must be set to Emdeon®. This
feature is NOT available to those using ‘Other’
clearinghouses. To the right there are two drop-down
fields. This is where the Default Adjustment Group Code
and Default Adjustment Reason Code are set. Click Save.
3) Now when making adjustments through the Insurance
Payments and/or Bulk Payment windows, these codes and
adjustment amounts will be defaulted. The user can
change the defaults if necessary, or simply save the
payment if all the defaults are correct.
User’s Guide – Patterson PTOS 5.6
Billing  94
Insurance Payment Windows
Payments with an amount greater than the balance can now be
made in both the bulk and regular insurance payment windows.
Visual indicators have been added to warn you when an
overpayment is applied.
In the top grid, the Ins Pd Amt field turns orange with a tooltip to
indicate any previous overpayments already saved for that claim.
In the bottom grid, the Pay Amt field turns orange with a tooltip
indicating the overpayment amount for that particular charge. In
addition, orange text detailing the overpayment amount appears at
the bottom of the window near the distribution fields.
Example: A full insurance payment has been made on a claim where the patient has
already made a $20.00 payment. In this case, the $20.00 patient payment is moved to
unapplied so that the entire $100.00 insurance payment can be distributed to the claim.
X-Charge Electronic Payment Processing
To sign up for X-Charge Electronic Payment Processing services,
contact our eServices team at 800.824.4305 to enroll.
Introducing X-Charge - a complete electronic payment
processing system that is now fully integrated with PTOS 5.6.
To create a patient refund or other debit adjustment, selec the
Adjustments tab. Under Merchant Payment, select the dropdown arrow to use either the Credit, Debit or E-Check radio
button.
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Billing  95
To collect an X-Charge Co-pay payment from the Schedule,
right-click and select Collect Co-Pay.
In the Co-Pay window, select the payment type and Merchant
Payment information. Use your card reader as directed and
follow the prompts. Select the Collect Co-Pay button to complete
the transaction.
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Billing  96
System Voids on Overpayments
In order to make automatic entries easier to locate on reports,
these overpayments will now display with the same date as the
original transaction.
Note: Any transactions that you void from the cogwheel will still
post on the date in which the void was made based.
For example: Patient A comes in for treatment on 8/01/12.
That treatment adds up to $100.
The patient pays $50 on 8/01/12 toward that
treatment.
Insurance then sends a check on 8/15/12 for the
full $100.
The system will post the $100 insurance check to
the services.
The $50 patient payment will get moved to
unapplied.
The $50 unapplied patient payment AND the
system Void will be posted on 8/01/12.
Note: We also recommend that you do NOT backdate PTOS from
the login screen to make it easier to find any voids or re-entries
that you made in your system.
Patient Transactions
Summary Tab
Select Patient Transactions under Billing  Patient
Transactions. In the Summary tab, review a quick overview of a
selected account.
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Billing  97
Select a patient by using the patient search. Under Case
Description, select the desired case from the drop-down list.
Review the Location.

Under Activity, review Ins Unbilled, Charges, Payments,
Adjustments, Last Date Ins Billed, Last Date Pat Billed,
Last Code and Last Code Date.

Under Visit Limitations, review First Visit Date,
Authorization Expiration Date, Authorized Visits,
Actual Visits, Remaining Visits and Charge Limits.

Under Balance, review the Current, 30-59, 60-89, 90-119
and 120+ balances, Expected Primary Ins Bal,
Expected 2nd/Tertiary Ins Bal and Patient Balance.

Under Unapplied, review the Unapplied Balance.

Use the Cogwheel to access an additional menu.
Cogwheel
Select the Cogwheel icon in the upper right corner to access an
additional menu. Through Cogwheel, you can access:
User’s Guide – Patterson PTOS 5.6

Patient Editor – Open the Patient Editor for the selected
patient.

Bill Patient Now – Generate a patient statement.

Bill Insurance Now – Generate a patient claim.

Recreate Claims – Recreate a closed claim for the
selected patient.

Void Transaction – Nullify the selected transaction.

Modify Transaction – Edit the selected transaction.

Payments/Adjustments – Access the
Payments/Adjustments window.
Billing  98

Enter Charges – Enter charges to the patient’s account.
Overpayments - Patient Transactions
An icon displays
in the transaction history screen next to any
charge that has an overpayment. A tooltip on the icon also
displays the overpayment amount when you hover your computer
mouse over the icon.
When a charge with an overpayment is highlighted in the top grid,
the detail grid at the bottom of the window shows any overpaid
amounts with the text OVERPAYMENT in front of the description.
These OVERPAYMENT amounts are no longer applied to the
charge.
Example: The unapplied $20.00 patient payment becomes an unapplied overpayment
amount.
When a credit that was fully or partially moved to an unapplied
overpayment is highlighted in the top grid, the detail grid at the
bottom of the window shows the service code and the date of
service the credit was removed from.
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Billing  99
Example: The now unapplied $20.00 patient payment shows that it was once paid on the
PT EVALUATION charge.
History Tab
Select the History tab to view patient transactions by date. This
screen is a more detailed overview of the patient account
including:
User’s Guide – Patterson PTOS 5.6

Date – The date of the transaction

Code – The code billed on the transaction date

Description – The description of the code

TranType – The transaction type

Amount – The price attached to the code
Billing  100

Allow Amount – The amount expected to be paid by the
insurance company attached

Diff Between Chg/Allowed Amt –The difference between
the amount charged and the amount allowed by insurance

Co-pay – The patient’s co-pay amount

Expected Ins – The patient’s expected insurance amount

Insurance Paid – The amount paid by the insurance
company

Patient Paid – The amount paid by the patient

Adjustments – Any adjustments that have been applied

Balance – The current balance of the case

AT – Account Type

PT – Therapist

Visit – Identifies appointments that qualify as visits

Unit – The number of units

DX – Diagnosis

Facility – The name of the treating facility

POS – Place of Service

Status – The current account condition

Modifier – Modifier

Claim # – The number associated with the claim

User – The person responsible for making entries.

Edit date – The date that edits were made to the
transaction
Select the checkbox Show Void Transactions to include voided
information in the transaction history.
Select the PTOS 3.6 Transactions button to view an overview of
transactions from the previous version of PTOS.
Select the Transaction Audit Trail button to view a report of
transactions for the selected account.
Use the Legends drop-down arrow to identify the color code for
each transaction type.
Selecting a transaction from the upper pane displays details in the
lower pane. To edit a line item, double-click and modify the
information on the right.
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Billing  101
Use the Cogwheel to access a menu of options. See the above
section for more information on the cogwheel menu.
Daily Transactions (Charges)
A window will be available where you can approve charges
entered in Charge Ticket within the system to post entered
charges to patients’ accounts. Once the charges are approved,
they are ready for insurance and/or patient billing. Also, when
accessed from Billing  Daily Transactions, you can see different
Transaction Types: Approved Charges, UnApproved Charges,
Payments, and Adjustments.
Approved Charges
After selecting the Transaction Type Approved Charges, select
the Facility ID, Entry User, Patient Name, Status and
Therapist. Select the desired Date of Service. Select Refresh.
Use the Cogwheel to access an additional menu of options.
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Cogwheel
Daily Transactions Report – Select this option to generate the
Daily Transactions report.
Void Transaction – Nullify the selected transaction.
Modify Transaction – Edit the selected transaction.
Patient Editor – Open the Patient Editor for the selected patient.
Bill Patient Now – Generate a patient statement.
Bill Insurance Now – Generate a patient claim.
Enter Charges – Enter charges to the patient’s account.
Payments/Adjustments – Access the Payments/Adjustments
window.
UnApproved
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Billing  103
After selecting the Transaction Type UnApproved Charges,
select the Facility ID, Entry User, Patient Name, Status and
Therapist. Select the desired Date of Service. Select Refresh.
Use the Select All checkbox to select all available transactions.
To approve a charge, select the Approve button.
Use the Cogwheel to access an additional menu of options. See
Approved Charges for more information on the Cogwheel
options.
Payment
After selecting the Transaction Type Payments, select the
Facility ID, Entry User, Patient Name, Status and Therapist.
Select the desired Date of Service. Select Refresh to update the
transaction screen. In the Payment Details area, enter Charge
and Pay/Adjusts desired for the selected transaction.
Use the Cogwheel to access an additional menu of options. See
Approved Charges for more information on the Cogwheel
options.
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Billing  104
Adjustment
After selecting the Transaction Type Adjustments, select the
Facility ID, Entry User, Patient Name, Status and Therapist.
Select the desired Date of Service. Select Refresh to update the
transaction screen. In the Adjustment Details area, enter
Charge and Pay/Adjusts desired for the selected transaction.
In the Date of Service area, today’s date defaults as the Entry
From and To dates. You can leave all filters blank with only a
date range specified and Refresh.
Double-click on a charge to edit it. A message will be included to
run CCI /LCD AUDITS (if this option has been setup in Config
Parameters).
Charges are now ready for Insurance and/or Patient Billing.
Accounts Receivable is automatically updated.
A different Cogwheel icon Menu is available from this window:
Daily Transaction Report, Audit Codes, Void Transaction,
Modify transactions, Patient Editor, Bill Patient Now, Bill
Insurance Now, Enter Charges, and Payments/Adjustments.
Charges created from the Enter Charges screen will be
automatically approved.
Use the Cogwheel to access an additional menu of options. See
Approved Charges for more information on the Cogwheel
options.
For More Information on CCI
and LCD data, go to
www.cms.hhs.gov.
CCI/LCD Audits
During the Approve Charges process outlined above, you have
the option to run CCI/LCD Audits. The CCI Audits are updated
quarterly by CMS. LCD Audits are determined locally by financial
intermediaries. Multiple CCI or LCD Audits can be set up and
User’s Guide – Patterson PTOS 5.6
Billing  105
attach to the Account Type and the insurance company. This
allows the system to handle different allowances for states,
regions, etc.
CCI Audits
In the Cogwheel, select Audit Codes. This audit looks for
conflicting C.P.T. codes that should not be billed together and
gives you the opportunity to edit the charge and/or add a
Modifier.
LCD Audit
LCD Audits can be run simultaneously with the CCI Audit. The
LCD Audit is a check to ensure that C.P.T. codes and DX codes
are payable when billed together. If there is a conflict, the audit
will warn you that the C.P.T. Code will not be paid with that DX
code. You can modify the code from this screen and run the audit
again to make sure it passes.
Void a Transaction
Void a transaction that was entered incorrectly by removing the
charge. In the Daily Transactions or Patient Transactions screen,
select the Void Transaction from the Cogwheel menu
 Void a Charge – Select the Charge that needs to be
removed and void the entry. AR totals will automatically
recalculate based upon this change. Charges that have
payments and adjustments posted cannot be voided.
 Void an Adjustment – Select the Adjustment that needs
to be removed and void the entry. AR totals will
automatically recalculate.
 Void a Payment – Select the Payment that needs to be
removed and void the entry. AR totals will automatically
recalculate.
Applying Co-pay
Most patients must pay a Co-pay upon arrival for their
appointment. There are two ways to post a Co-pay in the system.
 Unapplied Amounts – Select Scheduler on the PTOS
Menu Bar. All appointments with Co-pays will be available
and you can pay any amount. Those amounts are
considered unapplied amounts. Unapplied amounts can
be applied to all transactions. This method is the quickest
and easiest way to post the Co-pay and provide the patient
with a receipt showing the Co-pay was posted to their
account.
 Default to Co-Pay – In the Payments/Adjustments tab,
make an account payment. Payments will default to pay
Co-Pay first before applying payments to other services.
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Billing  106
Auto-calculating Accounts Receivable
Accounts Receivable automatically calculates after changes have
been made so that all reports and account balances are correct.

Patient Editor  Patient Case  Acct Type

Patient Editor  Bill tab  Co-Pay

Billing  Patient Transactions  Transaction History  for
Voiding or Modifying Transactions
Account Aging
Accounts age daily from the Date of Service date in the patient’s
account.
Inactive Accounts
When entering transactions for an Inactive patient, a prompt
appears allowing you to reactive the selected patient.
Date Range Information
Date range information has been added to the statement billed
line in the Transaction History window for each individual
statement.
See the following example.
Claims
View Claim status in the Claims window. Select Billing  Claims
to view. Select the Facility.
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Billing  107
In the Claims status view drop-down menu, select from the
following options:

Un-Submitted

Un-Submitted Electronic

InProcess

Open

Rejected
Once you have selected the claim status, mark the desired claims
and select from the following options:
Print Image File – Select this option to capture a copy of the
electronic claim.
Note: Claim Notes can only be
added to one claim at a time.
Process – Select this option to submit claims to insurance
companies.
Claim Notes – Select this option to add and view notes
associated with the selected claim.
Preview – Select this option to preview the selected claim prior to
submitting.
Close Claim – Select this option to close the highlighted and
selected claims.
Create Additional Claim – Select this option to create another
claim based off of the selected claim.
eClaims Reports – Select this option to manually retrieve eclaims
reports from the clearinghouse.
Sort columns by selecting the column heading.
Use the quick navigate buttons to launch the following windows:

Patient

Transactions

Insurance

ERA Queue
Select Close to exit the Claim window.
Multiple Open Claims
When submitting multiple claims for a particular patient, it is
important to note that multiple open claims may have an effect on
your patient balance totals. These totals may appear artificially
inflated due to the way in which claims are estimated.
Select and Close Multiple Claims from the Claim Queue
Multiple claims may now be closed at one time in the Claim
Queue through Billing | Claims.
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Billing  108
Check all the claims that are to be closed and click the Close
Claim button. The Closing Insurance Claim window will appear for
each claim, prompting the user on how to handle additional
insurance or adjustments once the claim is closed.
Close Claim from Patient Editor
When inactivating insurance, if there are outstanding claims for
this insurance, the user will be taken to the Claim Queue to close
the claims. After reviewing and closing the claims, the user must
close the Claim Queue and then will return to the patient
insurance window to complete the insurance inactivation. This
happens from Patient Editor | Insurance Tab; select insurance
and choose the Inactivate button.
Change the Patient’s Insurance, but Leave Current
Claims Open
If Inactivate is selected and there are open claims or unprocessed
charges for this insurance, a new warning will appear.
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Billing  109

‘Yes’ will take you to the claims queue where you can
review and close any outstanding claims for this case prior
to inactivating the insurance.

‘No’ will continue the insurance inactivation process for this
case but will leave outstanding claims in the claims queue.

‘Cancel’ will abort the insurance inactivation process.
Recreate a Claim without having to Submit it for
Processing (Electronic or Print)
When the user chooses to recreate a claim, he/she now has the
option to ‘Send to Queue (Open)’. This option is available from
the Recreate Claims window. To get to the Recreate Claims
window, go to Patient Editor | Cogwheel | Recreate Claims.
This option is for all types of claims (Primary, Secondary, etc.) and
will be sent directly to the Claims Queue as ‘Open’ status.
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Billing  110
Create a New Claim without having to Submit it for
Processing (Electronic or Print)
When the user chooses to create a new claim, there is now the
option to Send to Queue (Open). This option is available from
three locations, the Insurance Billing Sort Tab (Option #1 - below),
from the Close Claim window (Option #2 - below), and from the
Create Additional Claims window (Option #3 - below).
Option #1
Option #2
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Billing  111
Option #3
HCFA Box 11A-C Secondary Claim
PTOS allows several options for how to populate HCFA boxes 9
and 11A-C. There is also the option that allows the user to print
primary insurance information in boxes 11A-C on secondary
claims and also provides the option to leave box 9 blank. To set
this option, go to System Tasks | Update Lists | Account Types.
Recreate a Secondary Claim without having to Recreate
the Primary Claim
Offices may have the need to recreate or reprocess a secondary
or additional claim without having the need to first recreate the
primary claim. PTOS 5.0 allows users to skip the step of
recreating the primary. From the Recreate Claims window, users
can highlight the secondary or additional claim and choose to
recreate it. This occurs under Billing | Patient Transactions,
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Billing  112
then access the Cogwheel to Recreate a Claim. This can also be
opened from Patient Editor | Cogwheel | Recreate Claims.
Patient Billing
Under the Billing menu, select Patient Billing to create an
individual or batch of billing statements.
In the Bill by Patient Number section, enter individual patient
numbers to generate up to six individual statements for patients.
In the Bill Account Type section, select the Account Type
checkbox.
In the Bill Range section, select the alphabetic range for patients
or manually enter an alphabetic range for selecting patients.
Select Process Now to begin processing Statements.
Select Send to Queue to send the statements to the Statement
Queue.
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Billing  113
Standard Options
In the Standard Options tab, select your statement options.
Under Billing Options, select Statement Format – GraphicalDetailed, Detail with Co-pay or Graphical-Summary.
Use the drop-down menu to select from the available Send To
options: Patient or Responsible Party. Use the drop-down menu
to select the Print Bills In either Alphabetical or Numeric order.
Enter the Amount Due Description if desired. This is a free-form
entry field. Anything entered into this field will be printed on
statements.
Select the checkbox Include Patient Billed Notes in Account to
add the billed notes to the current batch of statements.
Select the checkbox Print header and foother on every page if
desired. Leaving this option deselected will print the header on the
first page only and the footer on the last page only.
Under Limit Billing to, select from the available options:

Bill only Charges on which Insurance Payments have been
made.

Do Not Include any Charges on an Open Claim.

Exclude Inactive case.
Enter the following information for statements if desired:

User’s Guide – Patterson PTOS 5.6
Patients with Balance Greater than or Equal to: <enter
amount>
Billing  114

Patients who have not been billed since <select a date
from the drop-down list>

No Patient Payments received since <select a date from
the drop-down list>

Bill Cases with the Oldest Balance in Range <select
from the drop-down list>
Use the drop-down list to select the Facility ID if desired.
In the Bill by Date Ranges section, select the checkboxes:

Include Activity from past 30 days

Include Activity from <select date range>

Bill only if Patient has “Charges” in the Date Range
Specified
In Header options, select from the available remit to options:
Include Client Logo
Include Facility
Phone
Include eMail
Address
Include Facility
Name
Include Facility
Fax
Include Referring
Physician
Include Facility
Address
Include Office
Hours
Include Date of
Injury
Include Tax ID
Select the radio button to include the Web
Address, Diagnosis Code or Neither.
Include Employer
In Body options, select from the available options:
Select Include Balance
Forward to include balance
information from previous
months.
Include Billed Lines
User’s Guide – Patterson PTOS 5.6
Include Payments
Include Balance
Billing  115
Forward
Include
Adjustments
Show Expected Insurance Balance
Select the Finance Charges button.
Select the Include Finance Charges checkbox to add a finance
charge to statements. In the Account Type to Charge area,
select the Account Type checkbox to which you wish to apply
finance charges or leave blank for all.
In the Description field, enter the name you wish to use for the
finance charges. Enter the Percentage to Charge and the
Minimum Finance Charge Amount. Use the drop-down list to
select the Aging Category for Charge Accounts Over and select
All or Discharged in the Charge Patients area.
In the Notes section, enter the Note information to be applied to
the current batch of statements. Select Include Notes on
Statements to enter a statement note to be applied on all
statements.
Under Footer Options, select the checkboxes for Include Aging
and/or Include forms of payment accepted. Select the Add
Remittance Override checkbox to allow the patient payments to
go to an address other than the facility address.
When you have finished setting up your options, select Process
Now to begin processing this batch of statements. Select Send
to Queue to send this batch of statements to the Statement
Queue. Select Save Current Settings as Default to make the
selected options the default settings for statements.
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Billing  116
The Statement Queue
In the Statement Queue, review statements, remove statements
and make changes to statements prior to printing.
Select the Select All checkbox to mark all statements to be
processed. Otherwise, select each checkbox individually. Select
the Print Audit Trail Report checkbox to create a list of all
statements being processed. Select the Preview button to view
statements prior to printing. Select Process Now to begin
processing statements. Select Cancel to exit the Statement
Queue without processing.
Select the Print Image File checkbox to create an image file to
store.
Insurance Billing
Under the Billing menu, select Insurance Billing to create
patient insurance claims.
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Billing  117
Insurance Billing Sort Tab
In the Bill By Account Type section, select the checkbox
associated with the type of insurance claim you are billing. Select
the Bill only PTPN Accounts checkbox to only bill PTPN cases.
In the Bill by Date Ranges section, use the drop-down arrows to
select the From and To dates or leave blank for all dates.
In the Bill For Therapist section, use the drop-down menu to
select a therapist. Select Assigned or Treating. Use the dropdown menu to select the Facility ID or leave blank for all facilities.
In the Bill by Discipline section, use the drop-down arrow to
select the desired Discipline or leave blank for all disciplines.
In the Bill by Case # section, enter the patient name.
In the Bill Which Charges section, select from the following
checkboxes:

All Unbilled Charges

All Unpaid Charges

All Appealed
Select the Pre-billing Alert button to apply an alert to the selected
Account Type. Select Send to Queue to batch the selected
claims for later submission. Select Process Now to immediately
process the claims.
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Billing  118
Standard Options Tab
In the Standard Options, select the desired claim form to be
made available to you throughout PTOS.
In the UB04 Form box, select from the available options:

Line Item

Summary

Code Summary

Date Summary

Group Rev Codes
In the UB04 Box 39-41 Default drop-down, select the desired
default numbers to appear on insurance claims.
Select from the following additional options for all claims:

Include Payments

Include Adjustments

Include Insurance billed notes in Account

Print Mailing Labels
o

Insurance Labels per Line (1,3)
Automatically run Pre-billing Alert
Select the Set as Default Standard Options button to set the
selected options to default.
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Billing  119
Claims Queue Tab
In the Claims Queue, review claims, remove claims and make
changes to claims prior to printing. Select from the following
status view options:

Un-Submitted – Claims that have not been printed.

Un-Submitted Electronic – Claims that have not been
electronically submitted.

InProcess – Claims that have been submitted but
submission reports have not yet been downloaded.

Open – Claims that have been submitted and submission
reports have been downloaded and are awaiting payment.

Rejected – Claims that have been rejected by the
insurance company.
Or use the Select All checkbox at the top of the window.
Once you have selected the desired claim status, select from the
following options:
User’s Guide – Patterson PTOS 5.6

Facility Filter – Select the drop-down menu to select a
facility.

Print Image File – Select this option to create a print
image file that can be sent to clearinghouse as an
electronic claim option.

Process – Select this option to submit claims to insurance
companies.

Claim Notes – Select this option to view notes associated
with the selected claim.

Preview – Select this option to preview the selected claim
prior to submitting.
Billing  120

Close Claim – Select this option to close the selected
claim.

Create Additional Claim – Select this option to create a
new claim for additional insurance companies for the same
services without closing the primary claim.

Sort Queue – To sort items in the Queue, select the
heading name.

ERA Queue button – Select the ERA Queue button to
open the ERA queue (see below)

eClaims Reports – Select this button to open, purge, print
or generate reports on the status of eclaims. The following
is an example of the eClaims Reports screen.
In the eClaims Reports window, select from the follow options:

Get Report – Select this button to download outstanding
eClaim reports from the clearinghouse.

Purge Reports – Select this button to manually delete
existing claims reports.

Print Report – Select this button to print all available
reports.

Close – Select this button to close the eClaims Reports
screen.
Navigate To
Use the quick navigate buttons to launch the following windows:
User’s Guide – Patterson PTOS 5.6

Patient

Transaction

Insurance

ERA Queue
Billing  121
Select Close to exit the Claims Queue.
Re-creating a Claim
There are many options when re-creating a claim in PTOS.

To re-create a closed claim WITHOUT making any
changes, use the Recreate Claim option in cogwheel in
Patient Editor or Patient Transactions. To re-process an
open claim, simply highlight the claim in the Claims Queue
and process it again.

To re-create a closed claim after making a change to the
PATIENT or INSURANCE demographic/setup information
(e.g. ID#, address, HCFA setup, etc), use the Recreate
Claim from cogwheel in Patient Editor or Patient
Transactions. To re-process an open claim, simply
highlight the claim in the Claims Queue and process it
again.

To re-create a closed and processed claim after making a
change to the TRANSACTION, you will need to re-bill
using the Insurance Billing window.
eClaims Setup Tab
For assistance, please contact an eServices representative to
help set up your eClaims.
In the eClaims tab, under Clearinghouse Settings, enter the
following information:
User’s Guide – Patterson PTOS 5.6

eClaims Provider – Use the drop-down menu to select the
clearinghouse.

Login – Enter the User name

Password – Enter the password
Billing  122
Reports can also be manually
retrieved and purged in the
eClaims Reports screen
under the Claims Queue.

Other Clearinghouse File Path – Use the Browse button
to locate the clearinghouse file path if applicable. This
option is only available if you are using ‘Other’ as your
designated eClaim provider.

Print Image File Name – Enter the name desired for using
Print Image files for sending eClaims.
Under Default Reports to be Printed, select the checkbox
associated with the reports that you wish to print automatically
when processing claims.
Acknowledgment of
Receipt
Amend File Detail (RPT04A)
997
Batch & Claim Rejection (RPT05)
File Status (RPT02)
Amend Batch & Claim Rejection
(RPT05A)
File Summary (RPT03)
Provider Claim Status (RPT10)
File Detail (RPT04)
Special Handling/Unprocessed
Claims (RPT11)
Under Report Settings, select the checkbox Save Reports to
save these reports to Documentation. Select the number of days
after which you wish to Purge reports. Purged reports will be
completely removed from your PTOS database.
Select Save to save your selected setup. Select Default to
restore the default settings. Select the Cancel button to exit
without saving.
Auto Assign Payer ID
Any Insurance company that has been designated to Auto Assign
Payer IDs can be assigned or updated using the Auto Assign
Payer ID button in the eClaims Setup tab. To designate an
insurance company for auto assign, select System Tasks 
Update Lists  Insurance Companies.
Select the … button to open the Electronic Payer Name Matching
screen. In this window, select the PTOS payer and match them to
the Electronic Payer. Select OK.
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Billing  123
This will default the Auto Assign Payer ID checkbox in the
Insurance Company screen.
Auto Assign Payer IDs in the eClaims Setup Tab
Select the Auto Assign Payer ID button to update and assign any
new payer identification numbers.
Select Yes to continue. Select No to close without updating.
Setting up Unpaid Balances
To setup the Unpaid Balance defaults, go to Billing  Insurance
Billing and select the eClaims Setup tab. In the eClaims Setup,
select the checkbox Send Unpaid Balance Details to Additional
Insurance. Then use the drop-down boxes to select the default
group code and the default reason code.
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Billing  124
Using Unpaid Balances
Unpaid Balances are used when communicating electronically
with secondary or additional providers. For example, if the
Primary insurance paid $70 of a $100 charge, the unpaid balance
would be $30. Use the Unpaid Balance checkbox to submit the
$30 along with the reason/group codes for why it was not paid to
the Secondary payer. Unpaid Balances are only necessary
when using electronic claims to Secondary or additional
providers.
When closing a Primary claim with unpaid balance totals, verify
the defaulted Unpaid Balance amount. Select the Unpaid
Balance Details button to view service level details. Otherwise,
select OK.
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Billing  125
In the Unpaid Balance Details window, review the unpaid
balance. Unpaid Details convey information to additional payers
and will not impact the case balance.
Select the Balance button to assign portions of the Unpaid
Balance to different code groups.
Select OK to create the Secondary or Additional Claim with
Unpaid Balance information.
Claims
The claims queue can also be accessed by selecting Billing 
Claims.
Navigate in the Claims Queue using the navigation buttons.

Patient – Select the Patient button to open the Patient
Editor for the selected transaction.

Transactions – Select the Transactions button to open the
Transactions Summary and History window.

Insurance – Select the Insurance button to open the
Insurance information window for the selected claim.

ERA Queue – Select the ERA Queue button to open the
ERA window. (See Below)
ERA
ERA (electronic remittance advice) is an electronic file in an
industry-standard format called ANSI-835. The file contains a
number of transactions representing the payments and/or
adjustments that a payer has determined to be appropriate for
charges (claims) submitted by the provider.
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Billing  126
View ERA in Claims
In the Claim screen, select the ERA Queue button. The ERA
Queue appears.
The ERA Queue
In the Electronic Remittance Advice Queue, select the From and
To dates to view a range of claims. Select the Show button to
display ERAs.
In the ERA area, select a claim to view the basic information in the
upper portion of the queue. Select the View (+/-) hyperlink to view
the ERA. Select the Completed checkbox to mark the EOB as
completed.
In the ERA area, select a claim to view the Claim detail in the
lower portion of the queue. Select the EOB hyperlink to view the
Explanation of Benefits for the selected claim. Select the Claim
hyperlink to view the claim. ERAs with Provider level
Adjustments will receive multiple warnings.
The following is an example of the provider level adjustment
warning.
Select the Show Completed ERA checkbox to display closed
claim information. View the Legend to distinguish the meanings
of labels.
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Billing  127
Overpayments - ERA Payments
When an ERA is received that causes an overpayment, you are
warned when you attempt to save the ERA payment and are given
a chance to review the payment details before processing.
Bulk Payments
Select the Bulk Payment button to make an insurance payment
on a range of claims associated with the same Payer.
In the Bulk Payment window, select the Payment Date and
Payment Type. Enter the Bank # and Amount if necessary.
Select an Open Claim and view the Claim details in the lower
panel. Select Automatic or Manual Distribution.
NOTE: The check amount and the amounts distributed to claims
must match.
Date of Service Filter
Filter claims by Date of Service using a single date or a date
range. The filter defaults to empty to allow you to see all claims
prior to filtering.
For example: A claim with the service dates ranging from 6/1, 6/5
and 6/10 would display when filtered for date of service range 6/1
– 6/6 despite having the 6/10 dated entry.
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Billing  128
Other Clearinghouses
Use the Browse button to locate an ERA associated with a
Clearinghouse other than Emdeon®. We do not guarantee that all
clearinghouse information will be compatible with PTOS.
Claim Level Adjustments
There are three ways to handle claim level adjustments in PTOS
5.0:

Automatic Distribution – If you have your payments set
to automatic distribution, PTOS will distribute the
adjustment to the default adjustment type associated with
the claim.

Manual Distribution – If you have your payments set to
manual distribution, PTOS will prompt you to distribute the
adjustment amount.

Unapplied – When using manual distribution, you will have
the option to not distribute the adjustment amount thus
leaving it unapplied in the account.
Flexible Bulk Payment Distribution
Flexible Bulk Payment Distribution allows you to select the desired
claim and then automatically distribute the amount you entered
among the services on the selected claim. This gives you the
convenience of automatic distribution and the flexibility of manual
distribution.
Setting Up
In Config Parameters  Billing, select Use Partial Automatic
Distribution in Bulk. Select the Edit icon and change the Value
to Yes.
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Billing  129
Flexible Bulk Payment Entry
Enter the payment
amount.
Select the claim based on
Config Parameter
settings.
Automatically
distribute to services.
Our new distribution method allows you to select which claim on
which you wish to distribute payment.
1. Enter the Amount paid per claim. (In the above
example, $200)
2. Select the desired claim in the Claim level window.
3. Manually enter the payment amount on the claim.
PTOS will then auto-distribute the amounts to the services in the
lower services portion.
Reset Warning
Changing the check amount after you have begun entering
information will launch a warning message. This warning is to
inform you that making the change will result in all entries being
reset to $0.00.
Overpayments - Bulk Payment Windows
Payments with an amount greater than the balance can now be
made in both the bulk and regular insurance payment windows.
Visual indicators have been added to warn you when an
overpayment is applied.
In the top grid, the Ins Pd Amt field turns orange with a tooltip to
indicate any previous overpayments already saved for that claim.
In the bottom grid, the Pay Amt field turns orange with a tooltip
indicating the overpayment amount for that particular charge. In
addition, orange text detailing the overpayment amount appears at
the bottom of the window near the distribution fields.
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Billing  130
Example: A full insurance payment has been made on a claim where the patient has
already made a $20.00 payment. In this case, the $20.00 patient payment is moved to
unapplied so that the entire $100.00 insurance payment can be distributed to the claim.
HIPAA (ASC) X12 Version 5010 Standard
The HIPPA 5010 standard for electronic claims and ERA is an
industry mandate with a deadline of January 1, 2012. This
standard is utilized when processing both eClaims and ERA.
Only the Professional Claims 837-P and Remittance 835 are
included. Institutional 837 is not included.
If you are using PTOS eServices, the transition to 5010 will be
seamless. If you are using another clearinghouse for electronic
claims, please visit www.ptos.com/5010 for instructions on
downloading a 5010 test file to be sent to your clearinghouse for
approval.
NOTE: This only applies to electronic claims. If you are using
print image output files or paper claims, you will not be impacted.
To inquire further about PTOS eServices call 800-824-4305.
User’s Guide – Patterson PTOS 5.6
Billing  131
Worklist
Using the Worklist
The Worklist is a handy way of keeping appointments and notes
organized by Treating Therapist and Date.
Appointments
In the Appointments tab, use the drop-down lists to select a
Therapist and Date. In the Appt Filter, select Show All, Show
Incomplete and Show Complete.
Use the Refresh button to apply changes to the current view.
Use the Patient Chart button to open the Patient Chart window.
Notes
In the Notes tab, use the drop-down lists to select a Therapist
and Date Range. In the Status Filter, select Open Notes,
Closed Notes and Void Notes.
Use the Refresh button to apply changes to the current view.
Select Patient Chart to view chart information in the Worklist.
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Worklist  132
Interfaces
Using Interfaces
Interfaces allow you to seamlessly share data with third-party
software programs.
Config Parameters
To set up your Import and Export folders, select System Tasks 
Supervisor  Config Parameters. Use the drop-down list in
Config Group to select Interface.
Set your Data Export and Data Import to XML. Enter the path
(location) where you wish to store the exported data. The Export
folder path contains the exported patient demographics. Enter the
path (location) where manually imported XML files will be stored.
The Import folder contains any files that have been manually
imported.
Exported Files
Allow plenty of time for the
file export to complete.
PTOS 5.0 automatically exports all demographic files to the
designated Export folder. Once files have been exported to this
folder, a new file will be created in the export folder whenever files
have been added or edited.
User’s Guide – Patterson PTOS 5.6
Interfaces  133
One Time Export
To export your patient demographics to XML, select Special
Tasks  One Time Export.
The following window appears.
Select Yes.
Select OK. Exported files will now appear in the folder that was
designated in Config Parameters. Once files have been
exported to this folder, a new file will be created in the export
folder whenever files have been added or edited.
Import Files
To import XML files into PTOS, select Special Tasks  Data
Import.
The following window appears.
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Interfaces  134
Select OK. The following window appears.
Select OK.
Select OK.
Review the Import Summary. Select View Import Log to
preview a report of Import information. Select OK.
User’s Guide – Patterson PTOS 5.6
Interfaces  135
Reports
Report Options
Multiple options allow you to control how you receive report data.
Report Views
View your reports onscreen in either GridView or ReportView.
GridView – Select this option to view the information in a data
format. Use column headings to sort the data.
ReportView – Select this option to view the information in a
standard report format.
Export Options
Select the Export icon to select a format in which to save the
report to a location outside of PTOS.
Select Text, Excel, CSV, XML or HTML.
NOTE: Other software programs may be required for viewing
reports in other formats.
User’s Guide – Patterson PTOS 5.6
Reports  136
Favorites
To add a report to Favorites, select the Favorites icon which
appears as a yellow star. When a report has been added to
Favorites, the yellow star appears white and the report name
appears in the Favorites heading from the Reports drop-down
menu.
Aged Accounts Receivable Reports
Under Reports, select Aged Accounts Receivable Reports to
create a report with by selecting from the following options:
User’s Guide – Patterson PTOS 5.6
Facility
Select the desired facility from the
available options.
Account Type
Select the desired Account Type from
the available options.
Insurance Company
Enter an Insurance company to narrow
results by Insurance Company only.
Therapist
Select the desired therapist from the
available options.
Reports  137
Report Type
Select Summary or Detailed.
Case Status
Select the desired case status from the
available options.
Amount
Select Allowed Amount or Charged
Amount.
Include Zero
Select the checkbox to include zero on
the report totals.
Credit Balances
Select the checkbox to include credit
balances on the report totals.
Break down Balance
into Patient and
Insurance
Select the checkbox to display patient
and insurance balances separately.
Include Charge per day
Select the checkbox to include charge
per day.
Group Results By options:
Account Type
Select this option to group the report
results by Account Type.
Case Status
Select this option to group the report
results by Case Status.
Facility
Select this option to group the report
results by Facility.
Primary Insurance
Select this option to group the report
results by Primary Insurance company.
Therapist
Select this option to group the report
results by therapist.
Customized Date Range A/R Report
Select the Facility and Account Type from the available options.
Enter the Days Range amounts. Select Refresh to reflect the
changes in the data.
User’s Guide – Patterson PTOS 5.6
Reports  138
Analysis Reports
Under Reports, select Analysis Reports to create a report with the
following options:
User’s Guide – Patterson PTOS 5.6
Account Type Summary
This report shows how many new,
discharged, treated and patient marked
‘active’ for each Account Type. They are
grouped by the Account Type. It is only
considered a new patient if their first visit
date falls within the date range of the
report.
Billing Efficiency
This will show every claim or statement
that was sent during the period you
specify. Also shown, are the total number
of bills sent, the total amount billed, and
the smallest, largest and average size bill.
Collection/Transaction
Analysis
This report shows all charges, insurance
and patient payments, debit, and credit
adjustments, visits, and units for each day
of the month, or other time periods you’ve
selected with totals for each category. If
you wish, you can include a second line for
each day which will show the expected
amount and total payments received.
Diagnostic Statistics
This report prints in two different formats
depending on whether you select all
patients of DISCHARGED PATIENTS
ONLY.
Collections Efficiency
This report shows the total of charges
within the specified date range along with
the total insurance payments, patient
payments, adjustments, and the average
number of days it takes to collect the first
payment.
Delinquency Report
This is a list of all accounts that have notes
entered in Patient Editor field ‘Delinquent
Report Note’. Select accounts with
balances over 30, 60, 90 or 120 days or no
recent payments. Print one account type
or sort by patient number or by account
type.
Insurance Tracer
This report shows all ‘open’ claims.
Claims that have been marked ‘final’ will
not display.
Medicare Log
This option is designed as a summary of
activity for Rehab Agencies. Total
insurance and patient payments, and
credits for these charges are included.
Reports  139
Monthly Collections
This report shows the aging of charges
paid for the date range selected.
Outcome Edit List Report
This is a listing of discharged patients that
will be referenced in the #3.92 Outcome
Summary Report Outcome Reports
provide important management data.
When you select this option, the following
menu appears. You must first select
“Prepare Outcome Reports” option. This
compiles outcome data for all discharged
patients. It is similar to Prepare Aged
Accounts.
Outcome Summary
Report
This is a list of important management
data for all discharged patients.
C.P.T. Code Summary
The C.P.T. Code SUMMARY will then total
the number of times each procedure was
used during the period, the charges billed
for each procedure code and “I”
(individual) codes. You also have the
option of choosing to include “I” codes
ONLY. If you choose “I” codes only, all “I”
codes (individually entered charges) are
sorted and subtotaled by DESCRIPTION.
The report can be grouped by
THERAPIST, ACCOUNT TYPE or
LOCATION.
Referral Analysis
This report is valuable in analyzing which
doctors are sending profitable referrals.
Running the report on a monthly basis
provides an accurate gauge of increasing
or decreasing activity of various
physicians.
Treating Therapist Activity
This report is useful in measuring the
productivity of treating therapists. The
statistics can be used to assign patient
loads, calculate bonuses, and analyze
treatment trends.
Assigned Therapist
Activity
This report is useful in measuring the
productivity of assigned therapists. The
statistics can be used to assign patient
loads, calculate bonuses, and analyze
treatment trends.
Treatment Lists
Under Reports, select Treatment Lists Reports to create a report
with the following options:
User’s Guide – Patterson PTOS 5.6
Reports  140
Privacy (HIPAA)
Notification
This report shows patients and their HIPAA
Authorization and Privacy Notification dates.
Discharge/Inactive
This report shows patient cases by
Discharge Date, Condition and/or Inactive
Patients with their first and last visit dates.
Dropout
This report shows the patients considered as
‘dropouts’.
Notes
This report shows Case Notes and/or
Additional Notes on patient cases.
First/Last/Return Visits
This report shows patients by their first, last
and return visit dates.
Diagnosis List
This report shows patients by their Primary
Diagnosis and other relevant details.
Injury Area/Date
This report shows patients by their injury
area and date.
Patients By Referral
This report lists Referring Doctor, Primary
Doctor, Attorneys or Case Managers with a
listing of the respective patients that have
been assigned to each.
Auth Alert/Remaining
Visits
This report lists cases that are within a
certain # of visits of the Auth Visit Limit
and/or cases where the Auth Exp Date falls
within the date range specified.
Patient Therapist
Listing
This report shows a listing of patients and
their Assigned Therapist.
Payment Plan
This report lists patients who have a payment
plan amount set in Patient Editor.
Deductible
This report shows patients with a deductible
set in Patient Editor.
No Activity
A listing of patients who have had no activity
prior to a certain date.
Financial Lists
Under Reports, select Financial List Reports to create a report
with the following options:
User’s Guide – Patterson PTOS 5.6
Case Balance Report
This report shows all patients who have a
balance within the range specified, including
credit balances (Ex: Credit Balance = $150.00 to $-.01; Small Balance = $.01 to $25).
Charge Limit
This report will show patients who have met or
exceeded their charge limit.
Insurance Listing
This report lists all patients by either Primary,
Reports  141
Secondary, Third or Other Insurance within a
specified date range.
Responsible Party List
This report shows patients by Responsible
Party
Case Overview
This report shows patient cases and specific
details chosen in the filter.
Authorization Number
A listing of patients showing their
authorization number assigned within a
specific date range.
Demographic Lists
Under Reports, select Demographic Lists Reports to create a
report with the following options:
Patient Employer
This report shows a listing of patients by their
associated employers and/or occupation.
Patient
Address/Birthdate
This report is a listing of patient addresses
and their birthdates.
Patient Additional Info
This report is a listing of additional patient
information, including: email, Home #, Work
#, 1st visit, Last Visit, Referring Doctor and
User Defined Field.
Cover Sheet
This report provides a ‘cover sheet’
containing the data entered on the Patient
Data screens.
Code Lists
Under Reports, select Code Lists Reports to create a report with
the following options:
User’s Guide – Patterson PTOS 5.6
Account Type
This report is a listing of all Account Types set
in the system.
CCI Dataset
This report is a listing of CCI Edits and the
respective information attached to each.
LCD Dataset
This report is a listing of LCD Edits and the
respective information attached to each.
C.P.T. Codes
This report is a listing of C.P.T. Codes and the
info recorded for each in the system.
C.P.T. Group
This report is a listing of C.P.T. Groups
Terminology groups.
Referrals
This report is a listing of all Doctors, Attorneys
or Case Managers and pertinent information
Reports  142
for each.
Employers
This report generates a list of Employers.
Fee Schedules
This report generates a list of fees by Fee
Schedule.
ICD9 Codes
This report generates a list of International
Statistical Classification of Diseases and
Related Health Problems diagnosis codes.
Insurance Companies
A listing of all Insurance Carriers, their codes
and information as setup in the system.
Lookup Table
This report displays all of the abbreviation
codes located in the Lookup Table.
Employee
This report is a listing of all existing Employees
with their correlating information.
Payment Type
This report is a listing of the Payment Types.
Adjustment Type
This report is a listing of the Adjustment Types.
Transaction Lists
Under Reports, select Transactions Lists Reports to create a
report with the following options:
User’s Guide – Patterson PTOS 5.6
Adjustments
This report generates a list of adjustment
types.
Bank Deposit Slip
This report lists all information pertinent to the
Bank Deposit Slip.
Charges
This report shows all charges (billed and
unbilled) in a specified date range.
Charges and
Payments for Primary
Insurance
This report is a list of charges and payments
grouped and subtotaled by the patient’s
primary insurance.
Daily Transaction
Report
This report lists entered transactions for a
specified date range for all facilities.
Payments
This report is a list of payments subtotaled by
date.
Unapplied Monies
This report is a listing of all unapplied
payments and adjustments.
Unpaid Charges
This report is a listing of charges and their
remaining balances.
Voided Transactions
The report is a list of any voided transactions
within a specific date range.
Transaction Audit Trail
This report shows all Transactions for patients
within a specified date range.
Reports  143
Documentation Reports
Under Reports, select Documentation Reports to create a report
with the following options:
Document Listing
This report shows any documents that are
closed, open or all for a specific time period
and/or Therapist. The report is broken down
by Facility with totals per Facility and Grand
Totals for Patients/Case.
Open Notes Report
Displays active patient/cases that have one
or more open notes broken down by
Therapist.
Deferred Note Closing
Report
This report shows the number and
percentage of notes that are closed between
DOS + 3 days and those closed after 3 days.
Charge-Time Audit
Report
This report compares the documented time
(in a note) to the number of units for that
same visit. The note must be linked to the
appointment for the results to display.
Charge Ticket/Claim
Form comparison
Report
This report compares the charges entered
by the Therapist to the charges included on
the claim form for that same visit.
Scheduling Reports
Under Reports, select Scheduling Reports to create a report with
the following options:
User’s Guide – Patterson PTOS 5.6
Appointment List
This report is used to print a list of patient
appointments by Facility, Date and/or
Appointment Status.
Appointment
Reconciliation Report
This report is used to identify appointments
that have not been completed by the
Therapist or front desk.
Cancel/No Show
This report shows the number of scheduled,
cancelled and no-show appointments in a
user-specified time period for each therapist
in a facility or for all physicians referring to
the facility.
Co-Payment
Reconciliation Report
This report is used to reconcile the copayments collected (cash, check, creditcard, other) with the payments listed on the
bank deposit slip.
C.P.T. Utilization
Report
This report displays the average and total #
of units for each unique C.P.T. charge code
Reports  144
billed with the start/end period.
User’s Guide – Patterson PTOS 5.6
Daily Schedule
This report is a listing of patients scheduled
for a Facility and/or Therapist by
appointment date.
Patient Appointment
Reminder
The report is a list of patients with upcoming
appointments for confirmation.
Patient Sign-in Sheet
The report creates a form for collecting
patient signatures upon arrival.
Next Physician
Appointment Report
The report displays active patient/cases that
are within a selected time frame.
Superbill List
This report displays a list of patients who
have a scheduled appointment by specific
date. It can be printed for a specific patient
and date range.
Superbill Print
This report creates individual Super Bills for
patients. The Super Bill will only contain
C.P.T. Codes that were marked ‘To Include
on Super Bill’.
Therapist Schedule
Report
This report displays patient appointments for
the date range specified.
Weekly Appointment
Report
This report displays the number of
appointments/week for a five week period for
each Therapist in the facility or for all
physicians referring to the facility.
Reports  145
System Tasks
Supervisor
In this section, use System Tasks to manage a group of
supervisor items.
Config Parameters
Use the drop-down menu to select a Config Group. To edit an
existing entry, select the entry and select the Edit icon. See the
Using PTOS chapter for more information in setting up Config
Parameters.
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System Tasks  146
Data Sources
Multiple Data Sources can be
set up but at least one data
source must be active to prevent
loss of data.
Setup your data source information to designate the location of
your database information.

Data Source Name – Enter the Data Source Name.

DB Server – Enter your Database server location.

DB Name – Enter your Database Name.

DB User Name – Enter your Database user’s name.

DB Password – Enter your Database password.

Test Connection – Select the Test Connection button to
check the connection to your database server.
NOTE: Asterisk (*) denotes required field.
Facility
For information on setting up facilities, see the Using PTOS
chapter of this document.
Employee
For information on setting up employees, see the Using PTOS
chapter of this document.
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System Tasks  147
Merchant Services Setup
After completing your enrollment with eServices, set up your XCharge by selecting System Tasks  Supervisor  Merchant
Services Setup.
In Merchant Services Setup, under X-Charge Transactions,
select the checkboxes for Process Credit Cards, Process Debit
Cards and Process Electronic Checks. Enter your X-Charge
Username and Password and Merchant ID numbers for all
locations. Select Save to save.
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System Tasks  148
To setup payment information, select System Tasks  Update
Lists  Payment Types.
In the Payment Types window, new payment types are available
for Electronic Check and ATM/Debit Card.
To collect an X-Charge payment, select Billing 
Payment/Adjustments.
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System Tasks  149
In the Account Payment window, select the desired transaction.
Use your card reader and follow the prompts.
User Access Rights
For information on setting up User Access Rights, see the Using
PTOS chapter of this document.
User Groups
User Groups are assigned to employees in the Employee
screen. Another way to assign employees to User Groups is
under System Tasks  Supervisor  User Groups.
Select the User Group drop-down arrow to select a User Group.
Select Add Employees to User Group to add employees.
Select the checkbox associated with the desired employee.
Select OK.
To create a new User Group, select the Add icon or F2. Enter
the description information and save.
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System Tasks  150
To delete an existing User Group, select the desired group and
select the Delete icon.
Check for Updates
For information on checking for updates, see the PTOS chapter of
this document.
Update Lists
The Update Lists menu allows you to make modifications to your
lists. For more information on updating lists, see the Using
Update Lists section of the PTOS chapter of this document.
Login Summary
Select the Login Summary to view the login users for a userdefined date range.
Use the drop-down list to select a From and To date from the
calendar. The current date defaults in the From and To fields.
Use the drop-down list to select a User Name.
Select Refresh to update the list. Select Export to save this file in
another format elsewhere on your computer. Select Remove log
Data to delete the log file of login information.
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System Tasks  151
Currently Logged Summary
In the Currently Logged Summary tab, view a list of users that
are logged into PTOS. Select Remove to remove a user from the
system. Select Export to save this file in another format
elsewhere on your computer.
Object Lock Details
In the Systems Tasks, select Object Lock Details to locate and
release any locked files.
Select the specific file from the list and select the delete icon or
select the Clear All Locks button to unlock all files listed.
Export Application Errors
Use this option to save application errors to an external file.
These files may be useful for working with Support to diagnose
errors.
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System Tasks  152
Go to System Tasks | Export Application Errors. Use the dropdown list to select the file type. Select the Export button. Browse
to the desired location to which you wish to save the file. The
following window appears.
Select OK to save the file and return to PTOS.
Technical Support Utility
The System Copy and System Restore options are utilities to be
used by the Technical Support team when performing certain
tasks and maintenance. These copies should not be used in
place of an external system backup.
System Copy
For more information on
backing up your database
securely, contact your local
Hardware provider.
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System Tasks  153
Under System Tasks, select Technical Support Utility  System
Copy. Select the data source to be copied: Main and/or Archive.
Select OK to continue. Select Cancel to exit without copying your
database.
Select Yes to continue.
Select OK.
Select OK.
Copy Size
It is important to get a good backup of your PTOS data. If you
save documents larger than 4GB, the System Copy may not be
able to accommodate your entire backup.
If you have a larger than normal database or save large
documents, use an additional backup system to ensure that you
are backing up all of your data.
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System Tasks  154
Restore Copy
Under System Tasks, select Technical Support Utility  Restore
Copy. Use the drop-down list to select Main or Archive for your
data source. Select the Browse button to locate your copy file for
restoration.
Select Continue to begin restoring a copy. Select Cancel to exit
without restoring.
Select OK to continue.
Select OK to continue. Restart the application prior to continuing
to work in PTOS.
Select OK.
User’s Guide – Patterson PTOS 5.6
System Tasks  155
Special Tasks
Remove Old Accounts
Under Special Tasks, inactivate and archive your data.
Inactivate Cases
To remove discharged or otherwise completed cases from menus,
use the Inactivate Cases option.
Prior to Inactivating cases, you must set the case to inactive
using the Cogwheel menu in Patient Case.
Archived cases cannot be
retrieved without restoring a
backup of your database. Do
not archive cases unless you
are completely finished with
them.
To inactivate cases, select Special Tasks  Remove Old
Accounts  Inactivate Cases. Select the Discharged prior to
date, the Last Visit prior to date, Dropped out prior to date and
Last Payment made prior to. Under Case Status, select Active
Cases, Discharged Cases or Show All. Select the desired
patient to be inactivated or use the Select All checkbox.
Choose Inactivate & Archive to inactivate the selected patient(s)
and archive the information. Choose Inactivate to inactivate the
patient without archiving. Select Close to exit.
Archive Patients
To archive patients, select Special Tasks  Remove Old Cases 
Archive Patients.
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Special Tasks  156
Select OK to continue.
Archived cases cannot be
retrieved without restoring a
backup of your database. Do
not archive cases unless you
are completely finished with
them.
Select the name of the database that you wish to access. Select
the Choose checkbox for the desired patient or select the Select
All checkbox. Select the Archive Data button.
Add/Update Client Logo
Add your logo to be used on documents and reports. To add or
update your logo, select Special Tasks  Add/Update Client
Logo.
Note: Your image should be
no larger than 120 x 120
pixels.
Select the Add/Update Client Logo to upload a new logo image.
The image must be a JPEG. Select Remove Client Logo to
remove the logo without replacing the image. This logo will be
added to various reports and documents throughout PTOS.
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Special Tasks  157
Tools
Worklist
For information on Worklist, see the Worklist section of this
document.
Login as Different User
In the Tools menu, select Login as different user to switch
accounts without exiting PTOS.
Select the date using the calendar or select the Today button.
The calendar will default to today’s date. Enter the User Name
and Password and Login.
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Tools  158
Help
PTOS Help Menu
Select Help  PTOS Help to access a searchable help menu
designed to explain and inform.
Online Center
The Online Center is a hub of web-based information that is
available for PTOS users. Access these websites outside of
PTOS software.
Contact Support
Select Help  Online Center  Contact Support. The following
appears.
FAQ
FAQ is our searchable only database. To access FAQ, select
Help  Online Center  FAQ. Use FAQ to ask questions, retrieve
answers or learn more about PTOS.
Use the drop-down arrow to select a Patterson Product. Enter
keywords or phrases into the Search by Keyword field and select
Search.
User’s Guide – Patterson PTOS 5.6
Help  159
About PTOS
Select Help  About PTOS to review your individual license
information.
System Backups
Having a secure external backup is vital to protect your office
data. As of PTOS 4.5, it was be required that you use an external
backup system to obtain your nightly, monthly and yearly
database backups. As a result, the backup option in PTOS will no
longer be available as it is not sufficient to fully protect your
valuable data.
Creating Your Backup
Locate the following files and folders in your PTOS directory:
PatientStatements
RtfDocuments
ScanDocument
folder
folder
folder
SignedRtfdocuments
folder
Images folder
SignedPdfdocuments
folder
ClaimImageFiles
folder
email_template.txt
file
the xmlvalues.xml file within the CaseResultDocuments folder
These files contain your office’s important data and should be
backed up nightly.
In addition to the above files/folders from your PTOS directory,
you will want to create a System Copy from within your PTOS
system. This should be done daily. To create a system copy, go
to System Tasks | Technical Support Utility | System Copy. For
more information on how to create a .bak file, please visit FAQ.
Your .bak file as well as the files and folders listed under Creating
Your Backup should be backed up nightly, monthly and annually
using an external backup media.
Storing Your Backup
Once you’ve completed your database backup, it is important that
you store your data on an external media, preferably one that can
be stored off-site.
Please contact your local hardware provider for more information
on secure external backup systems for your office.
User’s Guide – Patterson PTOS 5.6
Help  160
Glossary of Terms
%
Allowed Amount
AMA
The percent sign is used throughout PTOS 5.0 like a Macro key. It replaces the
F2 key used in PTOS 3.5. Various boxes throughout PTOS 5.0 that ask you to
enter a code will allow you to type % and then press <Enter>. A box will appear
listing available codes, up to the first 500, for the specific field you are in. Doubleclick to make a selection from the box.
Set in FEE SCHEDULE code and/or C.P.T. code setup, this is the payment
amount the insurance allows for a specific C.P.T. code.
American Medical Association
A/R
A common abbreviation representing accounts receivable, which is the total dollar
amount owed to the facility by insurance and patients for services rendered.
Assigned Therapist
This is the provider who is established at the time of patient intake as the one
most likely to perform the patient’s care. However, depending on the particular
patient visit, other providers may treat the patient (i.e. the assigned therapist may
be busy, on vacation or have other reasons to delegate care to others). Such
other provider is called the treating therapist for a particular patient visit.
AT (account type)
A two-character code that classifies different accounting and insurance criteria so
that certain groups of people with a particular account type all have the same
criteria applied to them.
FEE SCHEDULE
Code (Billing Code
Translation)
A code defined for a specific insurance company within the code set up for
system administration. It is becoming more common for the patients’ primary
insurance to use one type of coding system and the secondary carrier to use
something different. Billing Code Translation automatically converts to the
appropriate code.
Billing Service
A type of PTOS customer who performs medical billing services for multiple,
usually unrelated medical offices. Billing services present several special needs
that are taken into account within PTOS 5.0. Billing services typically only use the
Billing module, not Scheduling or Documentation. Special licensure should be
obtained for billing services.
User’s Guide – Patterson PTOS 5.6
Glossary of Terms  161
CCI/LCD Audit
CMS 1500 (HCFA)
form
Cogwheel icon
Co-insurance
Co-pay
C.P.T. code
(Current Procedure
Terminology)
C.P.T. group code
Customer
DOS
DX
Insurance expected
amount
Extended amount
The CMS developed the National Correct Coding Initiative (NCCI) to promote
national correct coding methodologies and to control improper coding leading to
inappropriate payment in Part B claims. Go to
http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp?listpage=2.
Find Code Ranges 90000 – 99999 (for physical medicine or physical therapy…).
The CCI Audit prevents using conflicting C.P.T. codes, depicting when a modifier
should be used or two codes should be billed together. CMS updates these rules
every three months. PTOS 5.0 users receive special instructions on how to
manually update their system with these codes. LCD Audits can be run
simultaneously with the CCI Audit. The LCD (Local Coverage Determinations)
Audit is a check to ensure that C.P.T. Codes and DX Codes are payable when
billed together. The rules for LCD are determined by local financial intermediaries
http://www.medicare.gov/basics/lcds.asp. If there is a conflict, the audit will warn
you that the C.P.T. Code will not be paid with that DX code. You can modify the
transaction at that time and run the audit again to make sure it passes.
An insurance form used by most health professionals and insurance companies.
Appears in the upper right-hand corner of various screens throughout PTOS 5.0.
If the cogwheel icon option is chosen, a drop-down menu appears with different
functions that can be chosen.
The patient is responsible for a co-insurance amount, which is a calculation,
based on patient insurance benefits (ex: 20% of allowed amount on an 80/20
plan).
The dollar amount set in the Patient Editor that the patient is responsible to pay
(i.e. $10 co-pay per visit).
A C.P.T. code system describes medical and surgical procedures and services
performed by physicians and other health providers. The system was developed
by the American Medical Association (AMA) and serves a number of purposes. It
is essential to billing for patient care services. The 5-digit C.P.T. code is defined
by the AMA for all types of medical procedures. In PTOS 5.0, as in most medical
billing software systems, the C.P.T. code is an important parameter to keep track
of because this code appears in the billing form (whether submitted electronically
or on paper) in order to receive reimbursement. However, as strictly defined here,
a C.P.T. Code is only one type of procedure code. A yearly revision is made to
the C.P.T. CODE by the AMA. PTOS 5.0 currently does not have functionality to
automatically update these codes. Customers can manually update their codes
using the latest revision provided from the AMA website and/or handbook.
However, PTOS 5.0 allows the user to set up any combination of numbers and
letters as a C.P.T. /procedure code.
A collection of frequently used codes together under a different designated code
to make posting easier when repetitive procedures are performed.
The entity that licenses PTOS 5.0. It is typically a medical practice, but may also
be a billing service. A customer may consist of one or more facilities and one or
more users within a facility.
Date of Service.
The medical abbreviation for Diagnosis.
The amount the insurance is expected to pay based on calculations.
A calculation derived from the actual amount of the charge multiplied by the
number of units.
User’s Guide – Patterson PTOS 5.6
Glossary of Terms  162
Facility
ICD9 code
(International
Statistical
Classification of
Diseases and
Related Health
Problems)
ICODE
Modifier
A physical office or treatment center where medical services are provided to
patients. For example, if a single corporate entity (i.e. a partnership or
corporation) has three separate addresses where patients are seen, then this
counts as three facilities. If there is one physical address where patients are seen
(or billing is performed, as in the case of a billing service), but three different
entities (usually evidenced by different Tax Identification Numbers), then this also
counts as three facilities.
The ICD9 coding system is an international disease classification system that
groups related disease entities and conditions for the purpose of reporting
statistical information. The National Center for Health Statistics (NCHS) and
Center for Medicare and Medicaid Services (CMS) publish annual revisions of
these codes. PTOS 5.0 currently does not have functionality to automatically
update these codes.
Sometimes a procedure code doesn’t describe a specific treatment. An ICODE
can be entered for the charge and PTOS 5.0 will then allow a unique description,
units, amount and the allowed amount. This is a way to designate when extra
time or work was done on a patient (i.e. special splint, record copies). It is a onetime use code, not a permanent code.
This is a type of code (typically two numbers or letters) that conveys special
information about the charge being billed to an insurance carrier. For example, if
two charges are being billed that are generally considered by the insurer to be
medically inappropriate (and therefore not reimbursed), the use of a particular
modifier may signal special patient circumstances that enable the charge to be
paid. Or, as another example, providers may, under special medical
circumstances, receive reimbursement for patient care above the annual
Medicare reimbursement cap. The use of the modifier signals to the insurer that
these conditions have been met.
OT
The customer may be in violation of the law and suffer penalties if modifiers
are inappropriately used.
Occupational therapist.
POS
Place of Service
Provider
The individual person who provides a medical procedure. In the context of this
specification, this usually means a physical therapist (PT), occupational therapist
(OT), or speech therapist (ST), but could also mean a Chiropractor or MD.
Physical therapist.
PT
PTOS 5.0
A modular practice management software system written primarily in C# and
running on a SQL Server database.
PTPN
Physical Therapy Provider Network
REV code
A revenue code is a three-digit number that rehabilitation agencies use in
conjunction with a C.P.T. code to designate the type of discipline used to treat the
patient. Once set up, the REV code will print in its special space, box 42 of the
UB04 CMS 1450 form.
Speech therapist.
ST
Treating therapist
or PT
UB04 CMS 1450
form
The actual provider (i.e. physical therapist) who performed the procedure on a
patient.
An insurance form used by certain types of providers (States of Florida and
Michigan, Rehabilitation and Comprehensive Rehabilitation Facilities (CORF).
Requirements vary between states and/or agencies.
User’s Guide – Patterson PTOS 5.6
Glossary of Terms  163
Unapplied monies
Unit
UPIN
Payments posted to accounts that are not attached to any specific line item. The
money shows as unapplied monies or unapplied bal throughout PTOS 5.0
screens.
A medical billing term used in the industry that means a Unit of medical care. The
exact definition varies by the type of procedure. There are timed and untimed
procedures. For an untimed procedure, it is considered to be one unit regardless
of the amount of time it took to perform. For a timed procedure, the number of
units depends on the amount of time to perform the procedure. Fifteen minutes is
typically considered a unit, but can range between 8 and 22 minutes. A patient
visit can have one or more units, depending on the procedure.
Unique Physician Identification Number
User’s Guide – Patterson PTOS 5.6
Glossary of Terms  164
PTOS Website
Visit the PTOS website www.ptos.com to keep your business upto-date.
The PTOS website has several features available for your use.
Additional Seminars
A list of PTOS seminars is listed on the website. From the main
page select the Seminars tab to view the list. Registration for
these seminars is required and seating is limited so be sure to call
and reserve your seat!
FAQ
Also available on our website is FAQ, our online frequently asked
question database. Click the Support tab from the main page, and
then choose PTOS FAQs. FAQ is available to all PTOS users to
assist with any questions you may have. Not enough time to call
support? Use FAQ to help answer your questions!
Enhancement Suggestions
Do you have ideas on how to improve PTOS? Visit our website
and click the Enhancement Suggestions button on the main menu.
Enter your name, email address, and ideas and send them directly
to us!
Support
Select the Support button to access Live Chat. Live Chat allows
you to open a text dialogue with a Patterson technology
representative during business hours.
User’s Guide – Patterson PTOS 5.6
PTOS Website  165
Index
A
Adjustment Type 42
Appointment Warning Messages 90
Appointment/Block Hold Type 54
Archive Patients 151
B
Backup
Restore 149
Billing
Approve Daily Transactions 98
CCI/LCD Audits 102
Charge Ticket 89
Insurance Billing 114
Payments/Adjustments 91
Standard Options 111
Transaction History 97
Transactions 84
Void Transaction 103
C
CCI Datasets 50
Check For Updates 3
Claims 104
Electronic Remittance Advice 123
Claims Queue 117
Config Parameters 10
CPT Group 45
Enhancement Suggestions 160
Exit 2
Export Application Errors 147
F
Facility Information 5
Facility Logo 82
FAQ 154, 160
Fee Schedule 46
G
Glossary of Terms 156
H
HCFA/UB04 21
Help 154
Help Menu 154
I
Insurance Payments 92
Interfaces 130
L
LCD Datasets 49
Local Area Network 1
Logging On 2
Login Summary 146
Lookup Table 40
D
Documentation 72
Enter Charges 84
Note 75
Patient Chart 75
Pick Lists 74
Template Admin 72
M
Multiple Blocks 59
N
Note History 79
E
O
eClaims Setup 14
Email Reminders 68
Object Lock Details 147
User’s Guide – Patterson PTOS 5.6
Index  166
P
Patients 15
Bill Tab 20
Case Information 16
Diagnosis 17
Emergency Information 16
Employer Details 20
Insurance Tab 30
Notes Tab 31
Options Menu 32
Patient Information 15
Personal Information 16
Primary Care Physician 19
Referral/Employer 18
PTOS Website 160
R
Remove Old Accounts 151
Reports
Age Accounts Receivable 135
Analysis Reports 136
Code List 139
Demographic Lists 139
Documentation 141
Financial Lists 138
Scheduling 141
Transaction Lists 140
S
Schedule
Appointment Block/Void 70
Appointment Views 68
Calendar View 67
Edit Appointment 61
Transfer Appointment 69
Scheduling 52
Appointment 55
Appointment Block Hold Status 53
Appointment Card 66
Blocks 58
Cancelling Appointment 61
Checking In 61
Co-Pay 64
Enter Charges 65
Multiple Appointments 56
User’s Guide – Patterson PTOS 5.6
No Show 62
Note Complete 66
Print Superbill 67
Reminder Email Template 54
Resources 52
Right-click 64
Show CXL/NS Appointments 67
Voiding Appointment 63
Waitlist 70
Setting Up
eClaims 14
Employees 6
Employers 39
Payment Types 41
User Access 8
Zip Codes 40
Statement Queue 114
System Requirements 1
System Tasks 143
T
Tools 153
Transaction History 42
U
Update Code 34
Account Type Codes 37
CPT Codes 44
ICD9 Codes 44
Insurance Codes 34
Referral Codes 35
W
Worklist 129
Index  167
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